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

Effect of clinical pharmaceutical care intervention on maintaining treatment and quality of life in patients with schizophrenia

目的探讨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。方法将76例非急性期精神分裂症患者按患者家属意愿分为药学服务干预组和对照组。两组均接受抗精神病药物治疗,而干预组合并实施药学服务干预。于入组时、0.5年、1.0年及1.5年对两组患者进行简明精神病评定量表(BPRS)、WHO生存质量评定量表简表(WHOQOL-BREF)、治疗依从性、复发率和再住院率的评定。结果入组时干预组与对照组的治疗依从性、BPRS、WHOQOL评分的差异均无统计学意义(P>0.05)。随访0.5年时,干预组的治疗依从性明显高于对照组(P<0.05),而BPRS总分、复发率(5.3%vs24.3%)和再住院率(0.0%vs16.2%)均明显低于对照组(P<0.05)。随访1.5年时,干预组患者在WHOQOL的生理领域、心理领域、社会领域的评分明显高于对照组(P<0.01),环境领域评分亦明显高于对照组(P<0.05);治疗依从性明显高于对照组(P<0.01),BPRS总分、复发率(11.4%vs53.1%)和再住院率(5.7%vs37.5%)均低于对照组(P<0.01)。结论临床药学服务干预保证了精神分裂症患者维持治疗的依从性,使患者的病情更稳定且生活质量改善,可作为促进患者康复的有效手段之一。

Objective To investigate the effect of clinical pharmaceutical care intervention on maintaining treatment and quality of life in patients with schizophrenia.Methods Seventy-six cases of non-acute term patients with schizophrenia were divided into the pharmaceutical care intervention group and the control group accorded to family members＇ wishes.The patients in both groups received antipsychotic drug therapy but the patients in intervention group also received additional clinical pharmaceutical care intervention.The clinical outcome was simultaneously evaluated by the scale of brief psychiatric rating scale（BPRS）,the world health organization quality Of life-BREF（WHOQOL-BREF）,the compliance of drug treatment,the recurrent rate and re-hospitalization rate at 0,0.5,1.0 and 1.5 years following treatment.Results There were no significant differences in drug treatment compliance,total score of BPRS,score of each scale in WHOQOL-BREF between pharmaceutical care intervention group and the control group before treatment（P0.05）.Half year following treatment,the treatment compliance of the patients was significantly higher in the intervention group than in the control group（P0.05）,while the total scores of scale in BPRS,recurrence rate（5.3% vs 24.3%）and re-hospitalization rate（0.0% vs 16.2%） were significantly lower in the intervention group than in the control group（P0.05）.At following up 1.5 years,the scores of each factor in WHOQOL field of physiology,psychology and social relations of the patients,environmental field,were significantly higher in the intervention group than in control group（P0.01 or P0.05）,while the treatment compliance of the patients was significantly higher in the intervention group than in the control group（P0.01）.The total scores of scale in BPRS,recurrence rate（11.4% vs 53.1%）and re-hospitalization rate（5.7% vs 37.5%） were significantly lower in the intervention group than in the control group（P0.01）.Conclusions The intervention of clinical pharmaceutical care can secure the treatment adherence of non-acute term patients with schizophrenia,stabilize the condition,improve quality of life and can be used as an effective means to promote the rehabilitation of non-acute patients with schizophrenia.