An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand

Journal of Clinical Nursing - Tập 16 Số 7 - Trang 1302-1312 - 2007
Suparpit Maneesakorn1, Debbie Robson2, Kevin Gournay3, Richard Gray4
1Institute of Psychiatry, King's College London, London, UK
2Addictions
3King's College London
4Health Service & Population Research

Tóm tắt

Aim.  The aim of this paper was to evaluate the effectiveness of adherence therapy‐a brief intervention based on compliance therapy and motivational interviewing techniques‐in a sample of people with schizophrenia in Thailand.Background.  Poor adherence is problematic, but knowledge about how to improve medication adherence is limited. Studies focusing on the effects of interventions used to improve adherence have produced inconsistent outcomes and have been mainly conducted in western countries.Methods.  An exploratory single blind randomized controlled trial was conducted in Chiang Mai, Thailand. Thirty‐two patients with schizophrenia were randomly allocated to receive eight weekly sessions of adherence therapy or continue with their treatment as usual. Patients were assessed at baseline and after nine weeks. The primary outcome was overall psychotic symptoms. Secondary outcomes were general functioning, attitude towards and satisfaction with antipsychotic medication and medication side effects.Results.  The findings of this study indicated that patients who received adherence therapy significantly improved in overall psychotic symptoms, attitude towards and satisfaction with medication compared with treatment as usual but no significant difference was found in general functioning or side effects compared with treatment as usual.Relevance to clinical practice.  Adherence therapy has a positive impact on patients’ psychiatric symptoms, attitude towards and satisfaction with medication. Nurses can effectively deliver adherence therapy following intensive training.

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Tài liệu tham khảo

10.1097/00005053-199309000-00005

10.1034/j.1600-0447.2000.90061.x

10.1176/appi.books.9780890423349

10.1176/ajp.137.3.340

10.1002/9780470773666

10.1097/00004850-199501005-00008

10.1111/j.1600-0447.1994.tb01487.x

10.1176/ps.49.2.196

10.1192/bjp.166.5.650

DSM IV‐TR, 2000, Diagnostic and Statistical Manual of Mental Disorders

10.1001/archpsyc.1976.01770060086012

10.1093/schbul/23.4.637

10.1192/bjp.185.2.157

10.1046/j.1365-2850.2002.00474.x

Greco LD, 1987, Clinical epidemiology, questionnaire development: 3. Translation, Canada Medical Association Journal, 136, 817

Haynes RB, 2002, Interventions for helping patients to follow prescriptions for medications, Cochrane Database Systems Review, 288, 2880

10.1016/S0140-6736(96)01073-2

10.1002/sim.4780111603

10.1017/S0033291700050182

10.1192/bjp.165.5.695b

10.1016/S0165-1781(02)00030-6

Karnraiw P, 1998, The Consistency in Receiving the Prescription of Schizophrenic Out – Patients in Suanprung Hospital

10.1093/schbul/13.2.261

10.1136/bmj.312.7027.345

10.1192/bjp.172.5.413

Kingdon DG, 1994, Cognitive Behavioural Therapy of Schizophrenia

Larson ML, 1984, Meaning‐Based Translation: A Guide to Cross‐Language Equivalence

10.1056/NEJM198806303182605

Miller WR, 2002, Motivational Interviewing

10.7547/87507315-91-8-437

10.1046/j.0001-690X.2003.00193.x

Nilchaikovit T, 2000, The Thai version of the positive and negative syndrome scale (PANSS) for schizophrenia: criterion validity and interrater reliability, Journal of the Medical Association of Thailand, 83, 646

10.1192/bjp.183.3.197

10.1136/bmj.327.7419.834

Pulsiri N, 1992, Problems in Taking Anti‐Psychotic Medication of Schizophrenia in Nakorn Rajasima Psychiatric Hospital

10.1017/S0033291705004526

Rollnick S, 1999, Health Behaviour Change

Sackett DL, 1979, Compliance in Health Care

10.1002/sim.1519

SPSS Inc., 2003, SPSS for Windows, Rel.12.0.1

Tangtrongpairoj W, 1999, Risk factors of relapse in schizophrenia in the Thai Neurological Institute: 5th edn, Thai Department of Mental Health Conference

Thai Commercial Bank, 2006, Currency Exchange Rates

10.1192/bjp.180.6.523

World Health Organization, 2002, Guidelines for ATC Classification and DDD Assignment