出院后精神分裂症患者服药依从性电话和短信干预的1年随访  

Telephone and texting interventions for medication adherence of discharged patients with schizophrenia: A one-year follow-up study

作　　者：屈金莲[1] 张涛[1] 宋杰[1] 房海英[1] 

机构地区：[1]山东省胜利油田胜利医院精神科,山东东营257055

出　　处：《中国心理卫生杂志》2015年第9期656-661,共6页Chinese Mental Health Journal

基　　金：山东省胜利油田胜利医院科研基金资助课题(SL2010N91)

摘　　要：目的:探讨以问题解决为基础的电话和短信干预改善出院后精神分裂症患者服药依从性的效果。方法:将178例出院精神分裂症患者随机分为电话干预组(63例)、短信干预组(n=61)和对照组(n=54),电话和短信干预组患者接受"立足于解决问题干预"的服药依从性干预,三组患者均接受常规治疗并于基线和第1、3、6、9和12个月时进行服药依从性、阳性和阴性症状量表(PANSS)评估。结果:整体上,电话组的服药依从性评分显著高于短信组(P<0.001),短信组服药依从性评分高于对照组(P<0.001);电话组和短信组的PANSS评分差异无统计学意义(P=0.115),但均低于对照组(P<0.001);随访期间,对照组的再住院率高于电话组和短信组(9.3%vs.0%、1.6%,P=0.014)。结论:以问题解决为基础的电话和短信干预均可有效提高出院后精神分裂症患者的服药依从性,从而有利于减少患者的精神症状和降低再住院率。相对而言,电话干预能更好的改善患者的服药依从性。Objective： To explore the effects of problem-solving based telephone and texting interventions for medication adherence of discharged patients with schizophrenia. Method： A total of 178 discharged patients with schizophrenia were randomly assigned to telephone intervention （TI） group （n = 63）, text-messaging intervention （TMI） group （ n = 61）, and control group （ n = 54）. All patients were routinely treated, and patients in TI and TMI groups were given problem-solving based interventions. Medication adherence and psychotic symptoms were assessed by pill counting and the Positive and Negative Symptom Scale （PANSS） at baseline and the first, third, sixth, ninth and twelfth month. Results： Overall, patients with TI had higher medication adherence than those with TMI （P 〈0. 001）, and patients with TMI had higher medication adherence than that in control group （P 〈0. 001）. PANSS scores in TI and TMI groups were not significantly different （P 〉0. 05）, but significantly lower than control group （P 〈0. 01）. There was higher rate of re-admission in control group in comparison with TI and TMI groups （9. 3% vs. [0% and 1.6% ], P 〈0. 05）. Conelusion： It suggests that problem-solving based telephone and texting interventions are effective for improving medication adherence in patients with schizophrenia after their discharge from hospital, so as to reducing psychotic symptoms and lowering re-hospitalization risk. In comparison with TMI, TI has a better effect in improving medication adherence.

关 键 词：精神分裂症 问题解决 电话干预 短信干预 治疗依从性 随访研究 

分 类 号：R749.305.3[医药卫生—神经病学与精神病学]