中国西部某省社区精神分裂症患者药物治疗现状

Status of antipsychotic medication in patients with schizophrenia living in community in a western province of China

目的:了解社区精神分裂症患者药物治疗现状,为提升地区社区精神卫生服务质量提供参考。方法:在西部某省选择4个代表性县(区),对辖区所有在管的精神分裂症患者通过电话调查抗精神病药物使用情况。采用有序logistic回归模型和树模型探讨患者抗精神病药物治疗依从性相关因素。结果:1817例患者中接受抗精神病药物治疗者1480例,药物治疗完全依从者占65.41%,部分依从者占10.95%,不依从者占23.65%。多因素分析显示:非独居(OR=1.60,95%CI:1.13~2.28,P<0.01)、城市(OR=2.44,95%CI:1.73~3.43,P<0.001)、有残疾证(OR=2.21,95%CI:1.67~2.92,P<0.001)、近1年看过精神科医生的患者(OR=13.29,95%CI:8.83~20.00,P<0.001)的患者的服药依从性更好。结论:社区精神分裂症患者服药依从性的主要相关因素是精神专科服务利用能力,应重点关注农村地区精神卫生服务建设。

Objective:To explore the prevalence of and related factors of the compliance of antipsychotic medication in patients with schizophrenia in community,and to provide evidence for improving the quality of community mental health services.Methods:All eligible patients were enrolled in four counties(districts)selected from a western province.Telephone assisted interview was conducted to collect the data on antipsychotic medication use and compliance.Ordinal logistic regression and decision tree analysis were employed to identify predictorsof compliance.Results:Among 1817 patients,1480 were treated with antipsychotic medication,65.41%of them were fully compliant with the drug treatment,10.95%of them were partially compliant,and 23.65%of them were not compliant.Multivariate analysis showed that the patients living with family members(OR=1.60,95%CI:1.13-2.28,P<0.01),living in urban communities(OR=2.44,95%CI:1.73-3.43,P<0.001),possessing a disability certificate(OR=2.21,95%CI:1.67-2.92,P<0.001),having visited psychiatrists in the past year(OR=13.29,95%CI:8.83-20.00,P<0.001)had better compliance.Conclusion:The accessibility of mental health service may be one of the related factors of compliance of medication,further attention should be given to those patients living in the rural area.