健康管理随访对门诊首发精神分裂症患者服药依从性及复发的影响

Influence of the health management follow-up visits on medication compliance and the recurrence in the first-episode schizophrenia outpatients

目的：了解门诊首发精神分裂症患者实施健康管理随访干预对服药依从性及复发的影响。方法对136例经精神科门诊规范治疗后稳定的首发精神分裂症患者，随机分为研究组（68例）及对照组（68例），对照组进行常规门诊随访；研究组在此基础上实施健康管理随访干预。两组进行为期1年的随访，分别于入组时、24周、52周进行简明精神病量表（BPRS）、服药依从性量表（MARS）、疾病复发的评定，并分析影响服药依从性的相关因素。结果研究组患者在24周、52周MARS量表评分为（8．98±1．80）分，（7．02±1．90）分，明显高于对照组且差异有统计学意义（P＜0．01）；52周时研究组复发率为22．05％，对照组复发率为51．47％，两组比较差异有统计学意义（P＜0．01）；Logistic回归分析结果显示服药依从性与健康教育、服药次数、自知力、BPRS量表分值等因素有相关性。结论通过对门诊首发精神分裂症患者实施健康管理随访，能够提高患者服药依从性，降低疾病复发风险。

Objective To investigate the influence of the health management follow -up visits on the medication compliance and the recurrence of the outpatients with first-episode schizophrenia .Meth‐ods One hundred and thirty -six outpatients with first -episode schizophrenia with a steady condition after a regular therapy were randomly chosen ,and divided into the intervene group（68 patients） and the control group （68 patients） .The patients in the control group were treated in a regular way ;while those in the intervene group had health management follow -up visits as well as the regular treatment .After a one-year research ,both groups were evaluated with BPRS ,MARS and recurrence at the beginning ,at the end of six months and at the end of twelve months of the study .And the relevant factors of the medi‐cation compliance were analyzed .Results The scores of the MARS at the end of 24 weeks and at the end of 52 weeks of the study in the were （8 .98 ± 1 .80） ,（7 .02 ± 1 .90） respectively .There were significant differences between the two groups （P〈 0 .01） .The recurrence rate in the intervene group at the end of twelve months of the study was 22 .05% .There were significant differences from the control group （P〈0 .01） .The result of Logistic regression analysis shows the relevant factors of the medication compliance are Medication frequency ,insight and scores of BPRS successively .Conclusions The health management follow -up visits to the outpatients with first-episode schizophrenia can improve the medication compli‐ance and reduce the risk of recurrence of schizophrenia .