Comparison of Patient and Clinician Perspectives in the Assessment of Antipsychotic Medication Adherence

被引:31
作者
Barbui, Corrado [1 ]
Kikkert, Martijn [2 ]
Mazzi, Maria Angela
Becker, Thomas [3 ,4 ]
Bindman, Jonathan [5 ]
Schene, Aart [2 ]
Nose, Michela
Helm, Hedda [3 ]
Thornicroft, Graham [5 ]
Tansella, Michele
机构
[1] Univ Verona, Policlin GB Rossi, Dept Med & Publ Hlth, Sect Psychiat & Clin Psychol, IT-37134 Verona, Italy
[2] Univ Amsterdam, Acad Med Ctr, Dept Psychiat, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Leipzig, Dept Psychiat, Leipzig, Germany
[4] Univ Ulm, Dept Psychiat 2, BKH Gunzburg, Gunzburg, Germany
[5] Kings Coll London, Hlth Serv Res Dept, Inst Psychiat, London WC2R 2LS, England
关键词
Treatment adherence; Patient perspective; Clinician perspective; RATING-SCALE; RISK-FACTORS; SCHIZOPHRENIA; THERAPY; RELIABILITY; VALIDITY; OUTPATIENTS; PEOPLE;
D O I
10.1159/000232973
中图分类号
R749 [精神病学];
学科分类号
100204 [神经病学];
摘要
Background: Factors influencing patient and clinician perspectives in the assessment of medication adherence have never been compared. Method: This study used baseline and 12-month follow-up data from the QUATRO study, an international multicentre study. At baseline, information on patient sociodemographic characteristics, treatment factors, psychopathology, functioning and experience of antipsychotic side effects was gathered. After 12 months of follow-up, psychopathology, functioning and patient experience of antipsychotic side effects were measured once more, and a patient and clinician rating of adherence was obtained by means of the Medication Adherence Rating Scale (MARS) and the Compliance Rating Scale (CRS). Results: During the recruitment period, 409 subjects with a diagnosis of schizophrenia were recruited. Patients were more often men and single. Mean age was 41.5 years. At the time of the assessment, more than 40% were unemployed and on average had been on antipsychotic treatment for more than 10 years. Nearly 70% were receiving second-generation antipsychotics, and 50% received adherence therapy during the 12 months after enrolment. The relationship between the MARS and the CRS scores showed only a small overlap (correlation coefficient = 0.26). In the multivariate model, the only factor significantly associated with both patient and clinician ratings of adherence was psychopathology. Unemployment and poor subjective tolerability of antipsychotics were significantly associated with low levels of patient ratings of adherence. Conversely, length of treatments and use of newer antipsychotics were significantly associated with better clinician ratings of adherence. Conclusion: Patient and clinician ratings of adherence do not measure the same dimension. Factors that may positively affect adherence in terms of compliance with prescribed medication regimens may not affect patients' views on adherence, and this should be taken into consideration when planning and negotiating treatment modalities with each individual patient suffering from schizophrenia. Copyright (C) 2009 S. Karger AG, Basel
引用
收藏
页码:311 / 317
页数:7
相关论文
共 27 条
[1]
Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care [J].
Ascher-Svanum, H ;
Faries, DE ;
Zhu, BJ ;
Ernst, FR ;
Swartz, MS ;
Swanson, JW .
JOURNAL OF CLINICAL PSYCHIATRY, 2006, 67 (03) :453-460
[2]
Sex differences in the subjective tolerability of antipsychotic drugs [J].
Barbui, C ;
Nosè, M ;
Bindman, J ;
Schene, A ;
Becker, T ;
Mazzi, MA ;
Kikkert, M ;
Camara, J ;
Born, A ;
Tansella, M .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2005, 25 (06) :521-526
[3]
Provision of services for people with schizophrenia in five European regions [J].
Becker, T ;
Hülsmann, S ;
Knudsen, HC ;
Martiny, K ;
Amaddeo, F ;
Herran, A ;
Knapp, M ;
Schene, AH ;
Tansella, M ;
Thornicroft, G ;
Vazquez-Barquero, JL .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2002, 37 (10) :465-474
[4]
Client Socio-Demographic and Service Receipt Inventory - European Version: Development of an instrument for international research - EPSILON Study 5 [J].
Chisholm, D ;
Knapp, MRJ ;
Knudsen, HC ;
Amaddeo, F ;
Gaite, L ;
van Wijngaarden, B .
BRITISH JOURNAL OF PSYCHIATRY, 2000, 177 :S28-S33
[5]
INSIGHT AND PSYCHOSIS [J].
DAVID, AS .
BRITISH JOURNAL OF PSYCHIATRY, 1990, 156 :798-808
[6]
A SELF-RATING SCALE FOR MEASURING NEUROLEPTIC SIDE-EFFECTS - VALIDATION IN A GROUP OF SCHIZOPHRENIC-PATIENTS [J].
DAY, JC ;
WOOD, G ;
DEWEY, M ;
BENTALL, RP .
BRITISH JOURNAL OF PSYCHIATRY, 1995, 166 :650-653
[7]
Antipsychotic medication adherence: Is there a difference between typical and atypical agents? [J].
Dolder, CR ;
Lacro, JP ;
Dunn, LB ;
Jeste, DV .
AMERICAN JOURNAL OF PSYCHIATRY, 2002, 159 (01) :103-108
[8]
Patterns and risk factors of change in somatic and mood symptoms among older adults [J].
Fonda, SJ ;
Herzog, AR .
ANNALS OF EPIDEMIOLOGY, 2001, 11 (06) :361-368
[9]
Adherence to treatment with antipsychotic medication and health care costs among medicaid beneficiaries with schizophrenia [J].
Gilmer, TP ;
Dolder, CR ;
Lacro, JP ;
Folsom, DP ;
Lindamer, L ;
Garcia, P ;
Jeste, DV .
AMERICAN JOURNAL OF PSYCHIATRY, 2004, 161 (04) :692-699
[10]
Adherence therapy for people with schizophrenia - European multicentre randomised controlled trial [J].
Gray, Richard ;
Leese, Morven ;
Bindman, Jonathan ;
Becker, Thomas ;
Burti, Lorenzo ;
David, Anthony ;
Gournay, Kevin ;
Kikkert, Martijn ;
Koeter, Maarten ;
Puschner, Bernd ;
Schene, Aart ;
Thornicroft, Graham ;
Tansella, Michele .
BRITISH JOURNAL OF PSYCHIATRY, 2006, 189 :508-514