TELEPHONE MEDICATION MANAGEMENT IN SCHIZOPHRENIA

精神分裂症的电话药物治疗

基本信息

批准号：
2883494
负责人：
Mark S. Salzer
金额：
$ 3.93万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-07-01 至 2000-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2883494
关键词：
antipsychotic agents clinical research functional ability health care service evaluation health education health services research tag hospital utilization human subject mental disorder chemotherapy outcomes research quality of life schizophrenia telecommunications telemedicine therapy compliance

项目摘要

Non-compliance with typical neuroleptic drugs is well established as a major factor in relapse and re-hospitalization of persons with schizophrenia. Non-compliance has typically been attributed to significant extrapyramidal side effects and lack of efficacy. Atypical antipsychotic drugs are expected to have some impact on non-compliance because of generally lower extrapyramidal side effects and better efficacy. Non-compliance with typical antipsychotics is well established, but no information is available on non-compliance with atypicals. While atypical antipsychotic agents are expected to have an impact on compliance, there will likely remain a need for additional compliance-inducing strategies, as depot administrations and attempts to change attitudes toward medications have not proven effective in the long-term. The purpose of this exploratory study is to collect data on compliance with new antipsychotic medications and to test the effectiveness of telephone medication management (TMM) on compliance with a population of persons with schizophrenia and schizoaffective disorders. The specific aims of this study are: 1) Examine whether compliance with atypical antipsychotic drugs will be better than that with typical neuroleptics; 2) Evaluate the hypothesis that patients in the TMM program will experience superior quality of life, enhanced functioning, and decreased symptoms; 3) Study whether patients in the TMM program will adhere more closely to medication regimens; and 4) Examine the impact of TMM on hospitalization rates. This exploratory study will utilize a randomized 2X2 design involving 96 persons diagnosed with schizophrenia. Research participants will be non-randomized to medication and randomized to the TMM condition or "treatment as usual." Those assigned to the TMM condition will initially meet with a TMM staffperson and discuss medication attitudes, develop strageies for taking medications on a consistent basis, and provide psychoeducation about medication side effects. The TMM staffperson will then follow this up with weekly telephone contacts in which they will inquire about compliance and conduct a brief clinical interview. The TMM staffperson will initiate appropriate interventions (i.e., schedule an appointment with the persons physician) to combat relapse and emerging side effects.

不遵守典型的精神安定药物已被证实是精神分裂症患者复发和再住院的一个主要因素。不依从性通常归因于显着的锥体外系副作用和缺乏疗效。非典型抗精神病药物预计会对不依从性产生一定影响，因为其锥体外系副作用通常较低且疗效较好。不遵守典型抗精神病药物的情况已众所周知，但没有关于不遵守非典型药物的信息。虽然非典型抗精神病药物预计会对依从性产生影响，但可能仍然需要额外的依从性诱导策略，因为从长远来看，长效给药和改变对药物态度的尝试并未被证明有效。这项探索性研究的目的是收集关于新型抗精神病药物依从性的数据，并测试电话药物管理 (TMM) 对精神分裂症和分裂情感障碍患者依从性的有效性。本研究的具体目的是：1）检验非典型抗精神病药物的依从性是否会比典型抗精神病药更好； 2) 评估参加 TMM 计划的患者将体验到更高的生活质量、增强的功能和减少的症状的假设； 3）研究参加TMM计划的患者是否会更严格地遵守药物治疗方案； 4) 检查 TMM 对住院率的影响。这项探索性研究将采用随机 2X2 设计，涉及 96 名被诊断患有精神分裂症的患者。研究参与者将被非随机接受药物治疗，并随机接受 TMM 条件或“照常治疗”。那些被分配到 TMM 病症的人首先将与 TMM 工作人员会面，讨论用药态度，制定持续服药的策略，并提供有关药物副作用的心理教育。然后，TMM 工作人员将每周进行电话联系，询问合规情况并进行简短的临床访谈。 TMM 工作人员将采取适当的干预措施（即安排与患者医生的预约）以对抗复发和新出现的副作用。