2-Way Pagers--Improve Schizophrenia Medication Adherence

双向寻呼机——提高精神分裂症药物依从性

• 批准号: 7094442
• 负责人: DELBERT G ROBINSON
• 金额: $ 22.16万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7094442
• 关键词: antipsychotic agents; behavior modification; behavioral /social science research tag; bioengineering /biomedical engineering; clinical research; clinical trials; cognition disorders; functional ability; human subject; human therapy evaluation; medical rehabilitation related tag; mental disorder chemotherapy; patient monitoring device; psychosocial rehabilitation; quality of life; schizophrenia; self care; telemedicine; therapy compliance

DESCRIPTION (provided by applicant): Medication non-adherence in schizophrenia (SZ), estimated to be as high as 89%, has serious, costly and potentially dangerous consequences including poorer illness course as well as increased risk for relapse, re-hospitalization and longer length of inpatient stay. Medication nonadherence is multidetermined, however neurocognitive (NC) deficits, prevalent in schizophrenia, appear to play a significant role in this disease. NC deficits are significant predictors of medication adherence and medication management skill learning and are robust predictors of functional disability, independent of psychopathology. Over the past three years, this applicant has (supported by a NARSAD Young Investigator Award) been developing a pager-based intervention to help psychiatric patients improve their level of independent functioning. The intervention is an adaptation of an approach originally designed for, and having demonstrated efficacy in, helping brain injured patients compensate for NC deficits by improving independent functioning. Results of our pilot study in patients with SZ support the efficacy of this intervention for improving psychosocial treatment adherence. The proposed study extends this line of investigation to target medication adherence to improve psychopathology, community tenure, disability, and quality of life in SZ patients. Phase 1 will test the feasibility of Electronically Assisted Medication Adherence (EAMA) (N=20), and will inform a detailed revision of the current Beta version of the intervention manual and refinement of the study protocol for Phase 2, a randomized controlled trial (30 treatment as usual, 30 TAU+EAMA) which will provide preliminary efficacy data. In each phase, consenting schizophrenia inpatients are enrolled and followed for 6 months after discharge and complete assessments (psychopathology, medication attitudes, disability, service utilization, quality of life) at multiple timepoints. Medication adherence will be assessed using the medication event monitoring system (MEMS), pill counts and self report ratings. Results of this R34 intervention development project will provide a blueprint for the optimal design of future fully powered efficacy and effectiveness trials

描述（由申请人提供）：精神分裂症 (SZ) 患者不服药的比例估计高达 89%，会带来严重、昂贵且潜在危险的后果，包括病情恶化以及复发、再住院和住院的风险增加。住院时间更长。药物依从性是多因素决定的，但精神分裂症中普遍存在的神经认知（NC）缺陷似乎在这种疾病中发挥着重要作用。 NC 缺陷是药物依从性和药物管理技能学习的重要预测因子，也是功能障碍的有力预测因子，与精神病理学无关。 在过去的三年里，该申请人（在 NARSAD 青年研究者奖的支持下）一直在开发一种基于寻呼机的干预措施，以帮助精神病患者提高独立功能水平。该干预措施是对最初设计用于帮助脑损伤患者通过改善独立功能来补偿 NC 缺陷并已证明有效的方法的改编。 我们对精神分裂症患者进行的试点研究结果支持了这种干预措施对于提高心理社会治疗依从性的有效性。拟议的研究将这一调查范围扩展到目标药物依从性，以改善 SZ 患者的精神病理学、社区保有权、残疾和生活质量。 第一阶段将测试电子辅助药物依从性 (EAMA) (N=20) 的可行性，并将通知当前 Beta 版干预手册的详细修订以及第二阶段研究方案的完善，这是一项随机对照试验 (照常进行30次治疗，30次TAU+EAMA），这将提供初步疗效数据。在每个阶段，同意的精神分裂症住院患者都会被纳入并在出院后随访 6 个月，并在多个时间点完成评估（精神病理学、药物态度、残疾、服务利用、生活质量）。将使用药物事件监测系统 (MEMS)、药丸计数和自我报告评级来评估药物依从性。 R34 干预开发项目的结果将为未来全动力功效和有效性试验的优化设计提供蓝图