Medication Adherence in Older Psychotic People

老年精神病患者的药物依从性

• 批准号: 6473873
• 负责人: JONATHAN P LACRO
• 金额: $ 41.77万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6473873
• 关键词: academic achievement; age difference; aging; antipsychotic agents; behavior therapy; behavioral /social science research tag; clinical research; disease /disorder proneness /risk; gender difference; group therapy; hospital utilization; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; longitudinal human study; mental disorder chemotherapy; mental health education; mental health services; mood disorders; motivation; patient oriented research; racial /ethnic difference; schizophrenia; therapy compliance

Description (provided by applicant): Psychoses are among the most common and serious psychiatric disorders. Currently, the most effective treatment for psychosis is symptomatic, and involves the use of antipsychotic or neuroleptic medications. Unfortunately, well-conceived pharmacologic regimens often do not achieve their goals because of poor medication adherence. Depending on study design, measurement method, and other factors, reported rates of adherence to antipsychotic medication range from 11 percent to 80 percent (average rate approximately 50 percent). This is of considerable public health importance as nonadherence with antipsychotic treatment leads to myriad clinical and economic burdens, including psychotic relapse, increased clinic visits, emergency room visits, and rehospitalization. The primary goal of the proposed project is to test the effectiveness of Medication Adherence Therapy (MAT) on improving medication adherence and reducing psychiatric hospitalization. MAT is a fifteen session (60-90 minutes each) multi-interventional program consisting of motivational interviewing, education, social skills and behavior modification. Individual sessions will be held on weeks 1 and 12 and small group sessions will be conducted during weeks 2 through 11. Three monthly booster group sessions will begin on week 16. As secondary goals we will identify risk factors for nonadherence in older psychotic patients and determine whether MAT has benefits that extend beyond adherence and hospitalization. We propose to recruit 240 persons 45 years of age or older with schizophrenia or schizoaffective disorder requiring maintenance treatment with an antipsychotic medication. We will employ a randomized, pre-test, post-test control group design to examine the effects of the experimental intervention (MAT) compared to a support group (Control) which will be time equivalent to the experimental intervention. Research evaluations consisting of comprehensive assessments of demographic and clinical factors (e.g., medication adherence, medication side effects, psychopathology, insight, health beliefs, quality of life, functioning, etc.) will be collected at baseline, and at 3 months (immediately post-intervention), 6 months, and 12 months.

描述（由申请人提供）：精神病是最常见和最常见的疾病之一。 严重的精神疾病。目前最有效的治疗方法是 精神病是有症状的，涉及使用抗精神病药或精神安定药 药物。不幸的是，精心设计的药物治疗方案往往不能 由于药物依从性差而实现了他们的目标。取决于学习 设计、测量方法和其他因素，报告的遵守率 抗精神病药物的使用率从 11% 到 80%（平均比例 约 50%）。这对于公共卫生具有重要意义 不坚持抗精神病药物治疗会导致无数的临床和经济损失 负担，包括精神病复发、就诊次数增加、急诊室 探视和再住院。 拟议项目的主要目标是测试其有效性 药物依从性治疗 (MAT) 可提高药物依从性 减少精神病住院治疗。 MAT 是十五节课（60-90 分钟） 每个）由动机性访谈组成的多重干预计划， 教育、社交技能和行为矫正。个别会议将 在第 1 周和第 12 周举行，小组会议将在几周内举行 2 至 11。三个月一次的强化小组课程将于第 16 周开始。 次要目标我们将确定老年人不依从的风险因素 精神病患者，并确定 MAT 是否具有超出以下范围的益处： 坚持治疗和住院治疗。 我们拟招募240名45岁以上精神分裂症患者 或需要维持治疗的分裂情感性障碍 抗精神病药物。我们将采用随机、预测试、后测试 对照组设计以检查实验干预的效果 （MAT）与支持组（对照组）相比，其时间相当于 实验干预。研究评估包括综合 人口统计和临床因素的评估（例如药物依从性， 药物副作用、精神病理学、洞察力、健康信念、质量 生命、功能等）将在基线和 3 个月时收集 （干预后立即）、6 个月和 12 个月。