精神分裂症患者服药依从性的评价方法(综述)

Assessment of compliance with antipsychotic treatment in schizophrenic patients: A review

服药依从性是影响精神分裂症患者治疗效果的重要因素之一。本文通过对国内外现有资料进行检索复习,总结了精神分裂症患者服药依从性的主要评价方法,可分为主观评价方法和客观评价方法两大类。主观评价方法从态度(药物态度量表、服药影响因素评定量表、药物依从性评定量表)和行为(Morisky量表、日常服药量表、简明依从性评定量表)两方面进行评价,客观评价方法包括服药记录、药片计数、处方药记录、电子监测、生物检测等,尽管对服药依从性实质是"患者的服药行为与医嘱的一致性"已有广泛认同,可操作性的评价方法也不断发展,但这些方法都有其局限性,根据实际情况同时采用主观与客观评价方法进行调查可以提高结果的准确性。发展效度、信度令人满意而又简单易操作的评价方法作为"金标准"是今后方法学发展上的突破点。

Medication compliance is one of the most important factors of treatment effect of patients with schizophrenia. This article summarized a variety of methods to measure medication compliance through literature review in order to provide evidence for choosing suitable method. Measures of medication adherence fall into two basic categories： subjective methods and objective methods. Subjective methods include attitude scales （ Drug Attitude Inventory, Rating of Medication Influences, and Medication Adherence Rating Scale） and behavior scales （Morisky Medication Adherence Questionnaire, Tablets Routine Questionnaire, Brief Adherence Rating Scale） . Objective methods include medication records, pill counts, prescription records, technology-assisted monitoring, and biologic measures. Although the definition of medication compliance has been widely agreed and the evaluation methods are developing, different methods have different limitations and a ＂gold standard＂ needs to be explored. Adopting both objective and subjective method can enhance the accuracy of results. Achieving a ＂gold standard＂ which is objective, effective, simple and convenient would be a big breakthrough in methodology.