Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS®) and its relationship to sociodemographic, clinical and psychopathological variables
Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS®) and its relationship to sociodemographic, clinical and psychopathological variables
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DOI：
10.1016/j.schres.2008.09.007
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发表时间：
2009-02-01
影响因子：
4.5
通讯作者：
Mayans, Teresa
中科院分区：
文献类型：
--
作者：
Acosta, Francisco J.;Bosch, Esperanza;Mayans, Teresa
背景资料：精神分裂症患者的不依从性很常见，并可能产生严重的后果;因此，与不依从性相关的变量的研究是一个优先事项。虽然MEMS设备被视为“参考标准”，用于评估的合规性，它已被用于在极少数已发表的study.Methods：遵守102例门诊诊断为精神分裂症根据ICD-10标准进行了评估。在79例口服抗精神病药物治疗的患者中，使用MEMS器械评估了3个月的依从性。基线评价包括社会人口统计学、临床、治疗相关和精神病理学变量。结果：42.3%的患者存在不依从行为。精神科医生的估计与MEMS结果之间的一致性是公平的，患者和亲属的估计与MEMS结果之间的一致性是轻微的。非依从性患者表现出较差的洞察力，概念混乱，刻板的思维和注意力差相比，依从性patients.Conclusions：很大比例的精神分裂症患者未能充分遵守其规定的治疗。精神科医生、患者和亲属高估了患者的依从性。权威的洞察力和增加的概念混乱与不依从性独立相关。识别与不依从行为相关的因素和减少这些行为的策略将有助于改善精神分裂症的预后。(C)2008 Elsevier B. V.保留所有权利。
Background: Noncompliance is common in patients with schizophrenia and can have serious consequences; therefore research of the variables associated with noncompliance is a priority. Although the MEMS device is regarded as the "reference standard" for evaluating compliance, it has been used in very few published studies.Methods: Compliance was evaluated in 102 outpatients diagnosed with schizophrenia according to ICD-10 criteria. Compliance was evaluated with the MEMS device for 3 months in 79 patients who were on oral antipsychotic treatments. Baseline evaluations included sociodemographic, clinical, treatment-related and psychopathological variables. The psychiatrist, patients and relatives also provided compliance estimates.Results: Noncompliant behaviors were observed in 42.3% of patients. Agreement between estimations by the psychiatrist and the MEMS findings was fair, and agreements between those of both patients and relatives and the MEMS findings were slight. Noncompliant patients showed poor insight, conceptual disorganization, stereotyped thinking and poor attention as compared to compliant patients.Conclusions: A large percentage of schizophrenic patients failed to adequately comply with their prescribed treatment. Compliance was overestimated by the psychiatrist, by patients and by relatives. Poorer insight and increased conceptual disorganization were independently associated with noncompliance. Identification of factors associated with noncompliance and strategies to reduce these behaviors would help improve the prognosis of schizophrenia. (C) 2008 Elsevier B.V. All rights reserved.