Compliance-Interventionen in der medikamentösen Behandlung Schizophrenieerkrankter

Zusammenfassung

Hintergrund: Non-Compliance (oder Non-Adherence) mit antipsychotischer Pharmakotherapie kommt häufig vor und stellt ein Risiko für psychotische Rückfälle dar, das wissenschaftlich sehr gut belegt ist. Compliance ist von großer Bedeutung für den Verlauf und die Behandlung schizophrener Psychosen. Ein Schwerpunkt der Forschung gilt der Compliance mit antipsychotischer Pharmakotherapie. Methode: Die Arbeit gibt eine Übersicht der Ergebnisse aus Metaanalysen. Literaturreviews der internationalen psychiatrischen Literatur seit 1990 zu Effekten von Interventionen, die zum Ziel haben, die Medikamentencompliance bei Schizophreniekranken zu erhöhen, werden zusammenfassend referiert. Ergebnisse: Es fanden sich acht aktuelle Übersichtsarbeiten zur Effektivität compliancesteigernder Maßnahmen bei Schizophreniepatienten. Interventionen zur Besserung non-complianten Verhaltens zeigten bislang wenig (Psychoedukation) bis mittelstarke (kognitiv-behaviorale und multimodale Interventionen) Effekte. Weitere relevante Befunde werden zusammenfassend berichtet und kritisch diskutiert.

Abstract

Background: Non-compliance (or non-adherence) with antipsychotic pharmacotherapy occurs frequently. In addition, there is overwhelming evidence that it constitutes a major risk factor for psychotic relapse. Compliance substantially affects course and treatment of schizophrenia. During the last decades, a large body of research on compliance with antipsychotic medication has been accumulated. Method: The authors provide an overview of meta-analyses. Reviews published since 1990 on effects of interventions aiming at increasing compliance with medication in people suffering from schizophrenia are summarized. Results: We found eight reviews which reported empirical findings on the efficacy and effectiveness of interventions with the goal of improving compliance. Interventions have shown limited (psychoeducation) to moderate (cognitive-behavioral and combined interventions) effects. Other relevant findings are summarized and discussed.

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1 Ausschließlich der besseren Lesbarkeit wegen wird die männliche Form verwendet. Natürlich sind mit Patienten auch Patientinnen, mit Ärzten auch Ärztinnen usw. gemeint.