社区医生督导对重性精神障碍患者服药依从性和疗效的影响  

The effect of community doctors' supervision on medication compliance and treatment effect in patients with severe mental disorders

作　　者：王西建[1] 焦宁波[1] 亢晓燕[1] 李琨[1] 庄蓉[1] 吴岳峰[1] 

机构地区：[1]陕西省西安市精神卫生中心,西安710061

出　　处：《国际精神病学杂志》2017年第3期450-453,共4页Journal Of International Psychiatry

摘　　要：目的探讨社区医生督导对重性精神障碍患者的服药依从性及治疗效果的影响。方法选取于2013年2月2日至2015年2月1日期间居住于同一社区的重性精神障碍患者175例,对所有患者进行六级危险性评估,依据临床表现对所有患者作四级管理分类,并根据管理分类,为每位患者制定个性化社区医生督导方案。2年后,收集所有患者服药依从率、症状好转率、社区集体康复活动参与率、肇事肇祸率等资料,并与2年前进行对比。结果与管理前相比,患者服药依从率从59.1%上升到70.2%;社区集体康复活动参与率从27.3%上升到70.1%;肇事肇祸率从44.4%下降到11.4%,差异具有统计学意义(P<0.01)。结论应用社区医生督导能有效提高重性精神障碍患者的服药依从性和疗效,对提高患者医疗效果有着积极作用。Objective To explore the effect of medication compliance and therapeutic effect on the patients with severe mental disorder in the supervision team of community doctors. Method Selected 175 cases of patients with severe mental disorders from February 2013 February 2, to February 1 , 2015 who living in the same community. Then, judge all patients by six levels of risk assessment. According to the clinical manifestations, class all patients for four management classification. And design personalized community physician supervision program for each patient. After 2 years, collect all medication compliance rate of patients, symptoms improved rate, the rate of participation in eom- munity rehabilitation activities, trouhlemaking rate, and compared with two years ago. Result Compared with the results of 2 years ago, the patient medication compliance rate rose from 59.1% to 70.2 %. The patient compliance rate increased from 59.1% to 70.2 %. Community collective rehabilitation activities participation rate rose from 27.3 % to 70.1%. The accident rate decreased from 44.4 % to 11.4 %. All p values 〈 0.05. Conclusion Application of community doctors supervision can effectively improve medication compliance of patients with severe mental disorders, and has a positive effect on improving the treatment effect.

关 键 词：重性精神障碍 社区医生 社区精神卫生服务 疗效 

分 类 号：R749[医药卫生—神经病学与精神病学]