首发精神分裂症患者应用三位一体药学服务的效果研究
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摘要
目的探讨三位一体药学服务干预对首发精神分裂症患者服药依从性、生活质量及疾病复发率、再住院率的影响。方法将首发精神分裂症患者60例,随机分为对照组和干预组各30例,均接受常规的抗精神病药物治疗,而干预组全程给予三位一体药学服务干预。于入院时、出院时及出院后3个月、6个月评定2组患者的服药依从性、WHO生存质量评定量表简表(WHOQOL-BREF)、疾病复发率及再住院率。结果 2组患者在入院时服药依从性、WHOQOL评分的差异均无统计学意义(P>0.05);出院后3个月,干预组的服药依从性高于对照组(P<0.05),复发率、再住院率与对照组无差异(P>0.05),WHOQOL的生理领域、心理领域及社会关系领域的评分高于对照组(P<0.05),环境领域评分亦高于对照组(P<0.05);出院后6个月,干预组的服药依从性高于对照组(P<0.05),复发率低于对照组(P<0.05),再住院率与对照组无差异(P>0.05),WHOQOL的生理领域、心理领域、社会关系领域及环境领域的评分均高于对照组(P<0.05)。结论三位一体药学服务干预可以提高首发精神分裂症患者的服药依从性、降低复发率,提高了患者生活质量,可作为精神分裂症患者康复的有效手段在精神科推广。
Objective To observe the influence of the trinity pharmaceutical care intervention on medicine compliance,quality of life,the recurrence rate and re-hospitalization rate of first-episode schizophrenic patients.Methods A total of 60 first-episode schizophrenics in our hospital were randomly divided into control group and intervention group,with 30 patients in each group,all of these patients received routine antipsychotic treatment,and the intervention group was additionally given antipsychotic medication.The treatment compliance,the World Health Organization quality of life-BREF(WHOQOL-BREF) scores,the recurrence rate and re-hospitalization rate were assessed on admission,at discharge and at 3 months and 6 months after discharge.Results There were no significant differences in drug compliance and scores of WHOQOL between the two groups on admission(P > 0.05).The medication compliance of intervention group was remarkably higher than that in the control group(P <0.05),the recurrence rate and re-hospitalization rate had no significant differences(P > 0.05),the scores of physiology,psychology,social relations and environment of WHOQOL in the intervention group were obviously higher than that in the control group after 3 months of discharge(P < 0.05).At 6 months after discharge,the medication compliance of intervention group was evidently higher than that in the control group(P < 0.01),the recurrence rate was lower than the control group(P < 0.05),and there was no significant difference in re-hospitalization rate between two groups(P > 0.05),while the scores of physiology,psychology,social relations and environment of WHOQOL in intervention group weresignificantly higher than that in the control group(P < 0.0 1).Conclusion Trinity pharmaceutical care can improve the medication compliance and reduce the recurrence rate of patients with first-episode schizophrenia,and improve patients' quality of life,so it can be used as an effective method for rehabilitation of schizophrenia patients.
Objective To observe the influence of the trinity pharmaceutical care intervention on medicine compliance,quality of life,the recurrence rate and re-hospitalization rate of first-episode schizophrenic patients.Methods A total of 60 first-episode schizophrenics in our hospital were randomly divided into control group and intervention group,with 30 patients in each group,all of these patients received routine antipsychotic treatment,and the intervention group was additionally given antipsychotic medication.The treatment compliance,the World Health Organization quality of life-BREF(WHOQOL-BREF) scores,the recurrence rate and re-hospitalization rate were assessed on admission,at discharge and at 3 months and 6 months after discharge.Results There were no significant differences in drug compliance and scores of WHOQOL between the two groups on admission(P > 0.05).The medication compliance of intervention group was remarkably higher than that in the control group(P <0.05),the recurrence rate and re-hospitalization rate had no significant differences(P > 0.05),the scores of physiology,psychology,social relations and environment of WHOQOL in the intervention group were obviously higher than that in the control group after 3 months of discharge(P < 0.05).At 6 months after discharge,the medication compliance of intervention group was evidently higher than that in the control group(P < 0.01),the recurrence rate was lower than the control group(P < 0.05),and there was no significant difference in re-hospitalization rate between two groups(P > 0.05),while the scores of physiology,psychology,social relations and environment of WHOQOL in intervention group weresignificantly higher than that in the control group(P < 0.0 1).Conclusion Trinity pharmaceutical care can improve the medication compliance and reduce the recurrence rate of patients with first-episode schizophrenia,and improve patients' quality of life,so it can be used as an effective method for rehabilitation of schizophrenia patients.
引文
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[5]喻跃国,汪林兵,郑顺,等.影响精神分裂症患者预后的多因素分析[J].现代实用医学,2015,11(27):1465-1466.
[6]翁永振.精神分裂症的康复操作手册[M].第2版.北京:人民卫生出版社,2016:175-332.
[7]王存民.影响精神分裂症患者药物治疗依从性的相关因素及干预措施[J].中国民康医学,2016,28(3):53-55.
[8]Buckley P F,Wirshing D A,Bhushan P,et al.Lack of insight in schizophrenia:impact on treatment adherence[J].CNS Drugs,2007,21(2):129-141.
[9]Rusch N,Todd AR,Bodenhausen GV,et al.Implicit versus explicit attitudes toward psychiatric medication:Implications for insight and treatment adherence[J].Schizophr Res,2009,112(1-3):119-122.
[10]Mortimer A,Williams P,Meddis D.Impact of side-effects of atypical antipsychotics on noncompliance,relapse and cost[J].J Int Med Res,2003,31(3):188-196.
[11]Sellwood W,Tarrier N,Quinn J,et al.The family and compliance in schizophrenia:the influence of clinical variables,relatives'knowledge and expressed emotion[J].Psychol Med,2003,33(1):91-96.
[12]Glick ID,Stekoll AH,Hays S.The role of the family and improvement in treatment maintenance,adherence,and outcome for schizophrenia[J].J Clin Psychopharmacol,2011,31(1):82-85.
[13]刘铁桥,杨德森,王小平,等.影响首次住院精神分裂症患者复发的多因素判别分析[J].中国神经精神疾病杂志,2000,26(5):265-267.
[14]刘国友,宋君伟,张文佳,等.综合干预对慢性精神分裂症患者的作用[J].中国健康心理学杂志,2016,24(6):820-823.
[15]张华东,苏慧,于成泉.临床药学服务干预对精神分裂症患者的药物维持治疗及生活质量的影响[J].中国神经精神疾病杂志,2010,36(8):454-457.
[16]刘东波,冯龙喜.药学干预对精神分裂症患者用药依从性和生活质量的影响[J].贵州医药,2016,40(7):695-696.
[17]胡源,冯蕾,赵敏,等.观察临床药学服务干预对首发精神分裂症患者服药依从性及疾病复发率的影响[J].中国医药指南,2015,13(2):153-154.
[2]Liberman R P,Mueser K T,Wallace C J.Social skills training for schizophrenic individuals at risk for relapse[J].Am J Psychiatry,1986,143(4):523-526.
[3]Oehl M,Hummer M,Fleischhacker W W.Compliance with antipsychotic treatment[J].Acta Psychiatr Scand,2000,(Suppl 407):83-86.
[4]江开达,李淑春,罗星光,等.精神分裂症病人维持治疗中的依从性研究[J].中华精神科杂志,1997,30(3):39-42.
[5]喻跃国,汪林兵,郑顺,等.影响精神分裂症患者预后的多因素分析[J].现代实用医学,2015,11(27):1465-1466.
[6]翁永振.精神分裂症的康复操作手册[M].第2版.北京:人民卫生出版社,2016:175-332.
[7]王存民.影响精神分裂症患者药物治疗依从性的相关因素及干预措施[J].中国民康医学,2016,28(3):53-55.
[8]Buckley P F,Wirshing D A,Bhushan P,et al.Lack of insight in schizophrenia:impact on treatment adherence[J].CNS Drugs,2007,21(2):129-141.
[9]Rusch N,Todd AR,Bodenhausen GV,et al.Implicit versus explicit attitudes toward psychiatric medication:Implications for insight and treatment adherence[J].Schizophr Res,2009,112(1-3):119-122.
[10]Mortimer A,Williams P,Meddis D.Impact of side-effects of atypical antipsychotics on noncompliance,relapse and cost[J].J Int Med Res,2003,31(3):188-196.
[11]Sellwood W,Tarrier N,Quinn J,et al.The family and compliance in schizophrenia:the influence of clinical variables,relatives'knowledge and expressed emotion[J].Psychol Med,2003,33(1):91-96.
[12]Glick ID,Stekoll AH,Hays S.The role of the family and improvement in treatment maintenance,adherence,and outcome for schizophrenia[J].J Clin Psychopharmacol,2011,31(1):82-85.
[13]刘铁桥,杨德森,王小平,等.影响首次住院精神分裂症患者复发的多因素判别分析[J].中国神经精神疾病杂志,2000,26(5):265-267.
[14]刘国友,宋君伟,张文佳,等.综合干预对慢性精神分裂症患者的作用[J].中国健康心理学杂志,2016,24(6):820-823.
[15]张华东,苏慧,于成泉.临床药学服务干预对精神分裂症患者的药物维持治疗及生活质量的影响[J].中国神经精神疾病杂志,2010,36(8):454-457.
[16]刘东波,冯龙喜.药学干预对精神分裂症患者用药依从性和生活质量的影响[J].贵州医药,2016,40(7):695-696.
[17]胡源,冯蕾,赵敏,等.观察临床药学服务干预对首发精神分裂症患者服药依从性及疾病复发率的影响[J].中国医药指南,2015,13(2):153-154.