棕榈酸帕利哌酮治疗依从性的相关因素及其对精神分裂症患者复发的影响

摘要

Objective To investigate the compliance of paliperidone palmitate long-acting injection (PP-LAI) in the treatment of outpatients with schizophrenia and its effect on relapse.Methods A follow-up study was conducted to investigate 104 schizophrenia patients treated with PP-LAI in Chengdu Mental Health Center from 2013 to 2017.General demographic data, treatment compliance with PP-LAI injection and drop-off during the 53-week follow-up period were collected and assessed by means of drug compliance questionnaire and telephone follow-up.The patients were divided into compliance group (n=44) and non-compliance group (n=60) based on whether they followed the doctor′s advice to take medicine or stopped medication on their own.Results There was no significant difference between the two groups in gender, age, education, social function or course of disease (P＞0.05), but there was significant difference in monthly income (P＜0.05).Of 104 patients, 26 had recurrence and 78 had no recurrence.There were 2 recurrences in compliance group (4.5％) and 24 recurrences in non-compliance group (40％).Logistic regression results showed that age [OR=1.059, 95％CI (1.011, 1.110), P=0.016], education background [OR=1.629, 95％CI (1.017, 2.609), P=0.042] and family′s monthly income [OR=0.454, 95％CI (0.265, 0.779), P=0.04] had significant effects on treatment compliance.Conclusion PP-LAI treatment compliance of outpatients with schizophrenia is not good.Age, educational background and family′s monthly income are the key factors that affecting the treatment compliance of outpatients with schizophrenia.The recurrence rate of patients with good compliance is low.%目的 调查分析棕榈酸帕利哌酮长效针剂(PP-LAI)治疗门诊精神分裂症患者的依从性及其对复发的影响.方法 采用随访的方法,调查2013至2017年在成都市精神卫生中心就诊并使用PP-LAI的104例精神分裂症患者.通过用药依从性问卷和电话随访的方式收集测评患者的一般人口学资料、注射PP-LAI的治疗依从性以及53周随访期内的脱落情况.按照持续遵医嘱治疗或是自行断药将患者分为依从组和非依从组,其中依从组44例,非依从组60例.结果 依从组和非依从组患者在性别、年龄、文化程度、社会功能和病程上的差异无统计学意义(P＞0.05),在家庭人均月收入上的差异有统计学意义(P＜0.05).104例患者中,有26例出现复发,78例未出现复发.依从组复发2例,占4.5％,非依从组复发24例,占40％.Logistic回归结果显示,年龄[OR=1.059,95％CI(1.011,1.110),P=0.016]、学历[OR=1.629,95％CI(1.017,2.609),P=0.042]及家庭人均月收入[OR=0.454,95％CI(0.265,0.779),P=0.04]对于患者治疗依从性有显著影响.结论 门诊精神分裂症患者PP-LAI治疗依从性不佳,年龄、学历和家庭人均月收入是影响患者治疗依从性的关键因素,依从性好的患者复发率较低.