DRUG TREATMENT REFUSAL IMPACT ON SEVERELY MENTALLY ILL

拒绝药物治疗对严重精神疾病患者的影响

• 批准号: 3384074
• 负责人: JULIE M ZITO
• 金额: $ 16.62万
• 依托单位: NEW YORK STATE CNCL FOR MTL HYGIENE PLNG
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-04-01 至 1993-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3384074
• 关键词: chronic disease /disorder; health behavior; health related legal; hospital length of stay; human population study; human subject; mental disorder chemotherapy; mental disorders; patient care management; therapy compliance

A prospective study of drug treatment refusal will be conducted in 180 state psychiatric hospital admissions, aged 18-55, who are involuntarily committed and legally competent. Three groups appropriately matched on key clinical variables will be studied: refusers who are referred for court decision to treat over the patient's objection (I), refusers who are not referred (II) and consenting patients (III). The course of the index episode the reasons for drug refusal, attitude toward medication and prior medication history of group I and II refusers will be determined . For group I refusers, the decision of the court and the satisfaction of the treating doctor will be determined. Time intervals related to the court process (pre, pending, post-adjudication) will be computed. The incidence and prevalence of drug treatment refusal as defined by court application or prior formal review will be compared with data from other states' formal review programs. For the three groups, patients will be characterized on sociodemographic, past and current clinical characteristics including SCID-P verified diagnosis, symptoms (BPRS or Hamilton scores), medications (specific drugs, daily dosages and chlorpromazine- equivalents for the antipsychotics) and side effects (SAFTEE). Assaultiveness, measured as the number of assault-related incidents/ seclusion/restraints/and transfers to a secure unit, will be compared among the three groups. Treatment outcome measures include discharge status at one-year, length of hospitalization (corrected for placement differences) and readmissions in one-year. From the comparison in the drug management and treatment outcome between consenting patients and the subgroup of severely mentally ill patients who must undergo court review for their refusal to accept medications, epidemiologically based patterns will emerge for pharmacologic treatments targeted to these difficult-to-treat patients.

对拒绝药物治疗的前瞻性研究将在180中进行 州精神病医院入院，年龄在18-55岁，不由自主地 致力于法律胜任。 适当匹配的三组 将研究关键的临床变量：被转介的拒绝者 法院决定对患者的异议进行治疗（i），拒绝者 未转介（II）和同意患者（III）。 路线 索引情节拒绝药物的原因，对药物的态度 I组和II组的先前药物病史将是 决定 。 对于I组，法院和法院的裁决 将确定治疗医生的满意度。 时间间隔 与法院程序有关（前，待处理，判决后）将是 计算。 药物治疗的发生率和患病率拒绝 法院申请或事先正式审查定义 来自其他州正式审核计划的数据。 对于这三组，患者将在 社会人口统计学，过去和当前的临床特征，包括 SCID-P验证的诊断，症状（BPRS或汉密尔顿评分）， 药物（特定药物，每日剂量和氯丙嗪 - 抗精神病药和副作用（Saftee）的等效物。 攻击性，以攻击相关事件的数量衡量/ 将比较隔离/约束/和转移到安全单位的 在三组中。 治疗结果指标包括出院 一年的住院时间（纠正）的状态 差异）和一年中的再入院。 从比较 同意患者和 必须接受法院的严重精神病患者的子组 审查他们拒绝接受基于流行病学的药物 对于针对这些的药物治疗的模式将出现 难以治疗的患者。