思覺失調症病人服藥遵囑與急性住院危險性研究

A Study on Medication Compliance and Risk of Acute Hospitalization in Patients with Schizophrenia

目的：精神疾病患者之急性住院發生常與其未能遵醫囑用藥有關，為瞭解藥物遵囑性與急性住院之相關性及相關影響因素，盼能控制這些因素進而降低病人的再住院率。方法：採用病例對照之研究設計，由門診與急性住院病房中採取立意取樣方式，各選取80位思覺失調病人為研究對象，使用問卷測量方式詢問病人之家屬有關於研究對象之用藥情形，以檢視服藥遵囑的程度。結果：病人用藥遵囑性之餘藥狀況得分會對於發生急性住院產生影響，餘藥狀況情況愈少其用藥遵囑性之餘藥狀況分量得分的愈高情況，每增加1分可以降低4%急性住院之風險。規則回診對於思覺失調症病人有較低的急性住院風險，且用藥遵囑性愈高其住院風險愈低，特別是在餘藥情況方面，病人餘藥性愈低表示愈遵從醫囑用藥，可以避免思覺失調病人急性住院之風險。結論：用藥遵囑性對於思覺失調病人急性住院之風險有關鍵性之影響，可以透過鼓勵病人及其家屬讓病人能有規律之回診及注意其餘藥之情況，將可以有效降低急性住院的發生。

Objectives. Acute hospitalization of patients with mental illness is often related to medication incompliance. This study investigated the correlation between medication compliance and acute hospitalization and relevant influential factors to reduce acute hospitalization rate by controlling these factors.
Methods. A case-control study design was adopted. Purposive sampling was conducted in the clinic and acute hospitalization wards to recruit 80 outpatients and 80 inpatients with schizophrenia. A questionnaire was administered on the patients’family members to inquire the medication situations of the patients and examine their medication compliance.
Results. The patients’“unused medicine”score in medication compliance affected acute hospitalization. Patients with less quantity of unused medicine had higher scores of“unused medicine”in medication compliance. One point in the“unused medicine”score lowered 4% risk of acute hospitalization. Regular return visits could lower the risk of acute hospitalization among patients with schizophrenia. Higher medication compliance resulted in lower risk of hospitalization. In particular, the patients with lower quantity of unused medicine, implying higher medication compliance, had a lower risk of acute hospitalization.
Conclusion. Medication compliance had a critical influence on the risk of acute hospitalization of patients with schizophrenia. Health professionals shall encourage patients and their family members to have the patients to have regular return visits and pay attention to the situation of unused medicines. In this manner, the occurrences of acute hospitalization can be effectively reduced.