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Fortschr Neurol Psychiatr 2019; 87(06): 348-356
DOI: 10.1055/a-0646-3951
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Lebensqualität als Zielkriterium in der Schizophrenietherapie

Quality of life as a target criterion in schizophrenia therapy
Monika Bullinger
1   Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie
,
Jens Kuhn
2   Johanniter Krankenhaus Oberhausen, Evangelischer Klinikverbund Niederrhein gGmbH, Klinik für Psychiatrie, Psychotherapie und Psychosomatik
3   Universitätsklinikum Köln, Klinik und Poliklinik für Psychiatrie und Psychotherapie
,
Karolina Leopold
4   Vivantes Klinikum am Urban, Psychiatrie, Psychotherapie und Psychosomatik
,
Wolfgang Janetzky
5   Lundbeck GmbH, Scientific Unit
,
Rita Wietfeld
6   Praxis Dr. Wietfeld, Fachärztin für Neurologie, Psychiatrie und Psychotherapie
› Author Affiliations
Further Information

Publication History

eingereicht 21 August 2017
Online-Publikation 12 December 2018

akzeptiert 19 June 2018

Publication Date:
12 December 2018 (online)

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Zusammenfassung

Die Berücksichtigung der Lebensqualität hat sich in den in den letzten 50 Jahren zu einem wichtigen Konzept einer patientenorientierten Medizin entwickelt. Mit ihm soll das subjektive Erleben der Patienten erfassbar und in seinen verschiedenen Dimensionen beschreibbar gemacht werden. Heute ist die Lebensqualität als patientenberichteter Endpunkt auch integraler Bestandteil der frühen Nutzenbewertung nach dem Arzneimittelmarkt-Neuordnungsgesetz (AMNOG). In der Therapie schizophrener Patienten hat sich die Verbesserung der Lebensqualität als akzeptiertes Zielkriterium allerdings erst mit Verzögerung etabliert.

Abstract

Consideration of quality of life has developed into an important concept of a patient-oriented medicine in the last 50 years. With it, it should be possible to capture the subjective experience of the patients and describe its different dimensions. Today, the quality of life as a patient-reported endpoint is also an integral part of the early benefit assessment under the German Drug Market Reorganization Act. In the treatment of schizophrenic patients, however, improvement in quality of life as an accepted target criterion has only been established with delay.

Schlüsselwörter

Lebensqualität - Schizophrenie - Lebensqualitätsforschung - Lebensqualitätsinstrumente - gesundheitsbezogene Lebensqualität

Key words

quality of life - schizophrenia - quality of life research - quality of life assessment instruments - health-related quality of life
 

  • Literatur

  • 1 World Health Organization Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York. , 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948
    PubMed
  • 2 World Health Organization First international conference on health promotion:. Ottawa Charter; Ottawa: 1986. www.who.int/hpr/docs/ottawa.html
  • 3 Patrick DL, Burke LB, Gwaltney CJ. et al. Content validity – establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1 – Eliciting concepts for a new PRO instrument. Value Health 2011; 14 (08) : 967-977
    CrossrefPubMedSearch in Google Scholar
  • 4 Bullinger M, Blome C, Sommer R. et al. Gesundheitsbezogene Lebensqualität – ein zentraler patientenrelevanter Endpunkt in der Nutzenbewertung medizinischer Maßnahmen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58 (03) : 283-290
    CrossrefPubMedSearch in Google Scholar
  • 5 Long PH. On the quantity and quality of life. Med Times 1960; 88: 613-619
    PubMedSearch in Google Scholar
  • 6 Elkinton JR. Medicine and the quality of life. Ann Intern Med 1966; 64 (03) : 711-714
    PubMedSearch in Google Scholar
  • 7 Galbraith JK. Economics and the Quality of Life. Science 1964; 145 (3628): 117-123
    CrossrefPubMedSearch in Google Scholar
  • 8 Johnson LB. Presidential election campaign. 1964. . In: Rescher N. , ed. Welfare. Social Issues in philosophical perspective. Pittsburgh: University of Pittsburgh Press; ; 1972: 60-66
    Search in Google Scholar
  • 9 Naber D. Subjective effects of antipsychotic drugs and their relevance for compliance and remission. Epidemiol Psichiatr Soc. 2008; 17 (03) : 174-176
    CrossrefPubMedSearch in Google Scholar
  • 10 Malm U, May PRA, Dencker SJ. Evaluation of the quality of life of the schizophrenic outpatient: A checklist. Schizophr Bull 1981; 7 (03) : 477-487
    CrossrefPubMedSearch in Google Scholar
  • 11 Heinrichs DW, Hanlon TE, Carpenter Jr WT. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10 (03) : 388-398
    CrossrefPubMedSearch in Google Scholar
  • 12 Deutschenbaur L. et al. Pharmakologische Langzeitbehandlung schizophrener Erkrankungen. Nervenarzt 2014; 85: 363-377
    CrossrefPubMedSearch in Google Scholar
  • 13 Juckel G. Therapieziel soziale Funktionsfähigkeit. Der Neurologe und Psychiater 2014; 15 (11) : 46-54
    PubMedSearch in Google Scholar
  • 14 Roll SC, Knecht G, Kuhn J. et al. Antipsychotika-Depotbehandlung im Wandel der Zeit. Nervenheilkunde 2016; 35: 41-49
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 World Health Organization (WHO). Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 1993; 2 (02) : 153-159
    CrossrefPubMedSearch in Google Scholar
  • 16 World Health Organization (WHO). The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995; 41 (10) : 1403-1409
    CrossrefPubMedSearch in Google Scholar
  • 17 Rose M. Der Begriff der Lebensqualität in der Medizin – was ist darunter zu verstehen? Frankfurter Forum: Diskurse 2016; 14: 6-13
    PubMedSearch in Google Scholar
  • 18 Aaronson NK. Quality of life: what is it? How should it be measured? Oncology (Williston Park). 1988; 2 (05) : 69-76 , 64
    PubMedSearch in Google Scholar
  • 19 Bullinger M, Hasford J. Evaluating quality-of-life measures for clinical trials in Germany. Control Clin Trials 1991; 12 (04) Suppl): 91S-105S
    CrossrefPubMedSearch in Google Scholar
  • 20 Tolman AW, Kurtz MM. Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: a meta-analytic investigation. Schizophr Bull 2012; 38: 304-315
    CrossrefPubMedSearch in Google Scholar
  • 21 Bestmann B. Messung von Lebensqualität. WINEG Summer-School, Hamburg 10. September 2015
    PubMed
  • 22 Spitzer WO, Dobson AJ, Hall J. et al. Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis 1981; 34 (12) : 585-597
    CrossrefPubMedSearch in Google Scholar
  • 23 Couman KD, Howes N, Hopkins J. et al. A comparison of health professionals’ and patients’ views of the importance of outcomes of bariatric surgery. Obes Surg 2016; 26: 2738-2746
    CrossrefPubMedSearch in Google Scholar
  • 24 Schäfer I, Burns T, Fleischhacker WW. et al. Attitudes of patients with schizophrenia and depression to psychiatric research: a study in seven European countries. Soc Psychiatry Psychiatr Epidemiol 2011; 46 (02) : 159-165
    CrossrefPubMedSearch in Google Scholar
  • 25 Kuipers JG. Therapieadhärenz bei Patienten mit Rheumatoider Arthritis: Studienkonzept und Zusammenhänge zwischen Adhärenz und psychosozialen Variablen. 43. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh). 2016 ; Poster EV. 22
    PubMed
  • 26 Rose M, Fliege H, Danzer G, und Klappe BF. „Gesundheitsbezogene Lebensqualität“ ein Teil „allgemeiner Lebensqualität“. In: Bullinger M, und Ravens-Sieber U. Jahrbuch der Medizinischen Psychologie. 2000. Göttingen: Hogrefe;
    Search in Google Scholar
  • 27 Rose M. Messung der Lebensqualität bei chronischen Erkrankungen. Habilitationsschrift, eingereicht am 22. Juli 2002 Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité
    PubMed
  • 28 Franz M, Meyer T, Reber T. et al. The importance of social comparisons for high levels of subjective quality of life in chronic schizophrenic patients. Qual Life Res 2000; 9 (05) : 481-489
    CrossrefPubMedSearch in Google Scholar
  • 29 Häfner H, Maurer K, van der Heiden W. ABC Schizophrenia study: an overview of results since 1996. Soc Psychiatry Psychiatr Epidemiol 2013; 48 (07) : 1021-1031
    CrossrefPubMedSearch in Google Scholar
  • 30 Röder-Wanner UU, Oliver JP, Priebe S. Does quality of life differ in schizophrenic women and men? An empirical study. Int J Soc Psychiatry 1997; 43 (02) : 129-143
    CrossrefPubMedSearch in Google Scholar
  • 31 Naber D. Subjective effects of antipsychotic drugs and their relevance for compliance and remission. Epidemiol Psychiatr Soc 2008; 17 (03) : 174-176
    CrossrefPubMedSearch in Google Scholar
  • 32 Karow A, Wittman L, Schöttle D. et al. The assessment of quality of life in clinical practice in patients with schizophrenia. Dialogues Clin Neurosci 2014; 16: 185-195
    CrossrefPubMedSearch in Google Scholar
  • 33 Bullinger M, Kirchberger I, Ware J. Der deutsche SF-36 Health Survey. Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instruments zur Erfassung der gesundheitsbezogenen Lebensqualität. Zeitschrift für Gesundheitswissenschaften 1995; 3: 21-36
    PubMedSearch in Google Scholar
  • 34 The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998; 28 (03) : 551-558
    CrossrefPubMedSearch in Google Scholar
  • 35 Naber N, Karow A, Lambert M. Psychosocial outcomes in patients with schizophrenia: Quality of life and reintegration. Curr Opin Psychiatry 2002; 15: 31-36
    CrossrefPubMedSearch in Google Scholar
  • 36 Sozialgesetzbuch (SGB) Fünftes Buch (V) § 137a SGB V. Im Internet unter https: / /www.gesetze-im-internet.de/sgb_5/__137a.html. Letzter Zugriff am 18.12.2016
    PubMed
  • 37 Püschner F. Analyse der regionalen psychiatrischen Versorgung im Rhein-Kreis Neuss aus Patienten- und Versorgerperspektive. Gesundheitsökonomie: Politik und Management, Band 11. Berlin: LIT Verlag Dr. W. Hopf; 2012
    Search in Google Scholar
  • 38 Sozialgesetzbuch (SGB) Fünftes Buch (V) -Gesetzliche Krankenversicherung - (Artikel 1 des Gesetzes v. 20. Dezember 1988 , BGBl. I S. 2477) SGB 5Ausfertigungsdatum: 20.12.1988 Stand: Zuletzt geändert durch Art. 5 G v.2.12.2014 I 1922
    PubMed
  • 39 European Medicines Agency. The patient’s voice in the evaluation of medicines. How patients can contribute to assessment of benefit and risk. 2013 . Im Internet unter: http: / /www.ema.europa.eu/docs/en_GB/document_library/Report/2013/10/WC500153276.pdf
    PubMed
  • 40 European Medicines Agency. Patients to discuss benefit – risk evaluation of medicines with the Committee for Medicinal Products for Human Use. 2014 . Im Internet unter: http: / /www.ema.europa.eu/docs/en_GB/document_library/Press_release/2014/09/WC500173511.pdf
    PubMed
  • 41 Patel S, Bakken S, Ruland C. Recent advances in shared decision making for mental health. Curr Opin Psychiatry 2008; 21 (06) : 606-612
    CrossrefPubMedSearch in Google Scholar
  • 42 Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V. (Hrsg.) S3-Praxisleitlinien in Psychiatrie und Psychotherapie. Band 1 – Behandlungsleitlinie Schizophrenie. Darmstadt: Steinkopff-Verlag; 2005
    Search in Google Scholar
  • 43 Hasan A, Falkai P, Wobrock T. et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry 2013; 14: 2-44
    CrossrefPubMedSearch in Google Scholar
  • 44 Jääskeläinen E, Juola P, Hirvonen N. et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull 2013; 39 (06) : 1296-1306
    CrossrefPubMedSearch in Google Scholar
  • 45 Chan KW, Wong MH, Hui CL. et al. Perceived risk of relapse and role of medication: comparison between patients with psychosis and their caregivers. Soc Psychiatry Psychiatr Epidemiol 2015; 50 (02) : 307-315
    CrossrefPubMedSearch in Google Scholar
  • 46 Voruganti L, Cortese L, Oyewumi L. et al. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side-effect profile and impact on quality of life. Schizophr Res 2000; 43 (2-3): 135-145
    CrossrefPubMedSearch in Google Scholar
  • 47 Naber D, Moritz S, Lambert M. et al. Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophr Res 2001; 50 (1-2): 79-88
    CrossrefPubMedSearch in Google Scholar
  • 48 Gründer G, Heinze M, Cordes J. et al. Effects of first-generation antipsychotics versus second-generation antipsychotics on quality of life in schizophrenia: a double-blind, randomised study. The Lancet 2016; 3 (08) : 717-729
    PubMedSearch in Google Scholar
  • 49 Priebe S, Bremner SA, Lauber C. et al. Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomized controlled trial. Health Technol Assess 2016; 20 (70) : 1-122
    PubMedSearch in Google Scholar
  • 50 Kaplan G, Casoy Zummo J. Impact of long-acting injectable antipsychotics on medication adherence and clinical, functional, and economic outcomes of schizophrenia. Patient Prefer Adherence 2013; 7: 1171-1180
    PubMedSearch in Google Scholar
  • 51 Kirson NY, Weiden PJ, Yermakov S. et al. Efficacy and effectiveness of depot versus oral antipsychotics in schizophrenia: synthesizing results across different research designs. J Clin Psychiatry 2013; 74: 568-575
    CrossrefPubMedSearch in Google Scholar
  • 52 Jones PB, Barnes TR, Davies L. et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry 2006; 63 (10) : 1079-1087
    CrossrefPubMedSearch in Google Scholar
  • 53 Falissard B, Sapin C, Loze JY. et al. Defining the minimal clinically important difference (MCID) of the Heinrichs-Carpenter quality of life scale (QLS). Int J Methods Psychiatr Res 2016; 25 (02) : 101-111
    CrossrefPubMedSearch in Google Scholar
  • 54 Naber D, Hansen K, Forray C. et al. Qualify: a randomized head-to-head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res 2015; 168 (1–2): 498-504
    CrossrefPubMedSearch in Google Scholar
  • 55 Bullinger M, Ravens-Sieberer U, Siegrist J. Gesundheitsbezogene Lebensqualität in der Medizin – eine Einführung. In: Bullinger M, Ravens-Sieberer U, Siegrist J. Lebensqualitätsforschung aus medizinpsychologischer und -soziologischer Perspektive. Göttingen: Hogrefe; 2000
    Search in Google Scholar
  • 56 Theisel S, Schielein T, Spießl H. Der “ideale” Arzt aus Sicht psychiatrischer Patienten. Psychiatrische Praxis 2010; 37 (06) : 279-284
    Thieme ConnectPubMedSearch in Google Scholar
  • 57 Bhatia R, Gibbins J, Forbes K. et al. „We all talk about it as though we’re thinking about the same thing.” Healthcare professionals’ goals in the management of pain due to advanced cancer: a qualitative study. Support Care Cancer 2014; 22 (08) : 2067-2073
    CrossrefPubMedSearch in Google Scholar
  • 58 Priebe S, Gruyters T, Heinze M. et al. Subjective evaluation criteria in psychiatric care – methods of assessment for research and general practice. Psychiatr Praxis 1995; 22: 140-144
    PubMedSearch in Google Scholar
  • 59 Ruggeri M, Nose M, Bonetto C. et al. Changes and predictors of change in objective and subjective quality of life: Multiwave follow-up study in community psychiatric practice. Br J Psychiatry 2005; 187: 121-130
    CrossrefPubMedSearch in Google Scholar
  • 60 Petkari E, Pietschnig J. Associations of quality of life with service satisfaction in psychotic patients: a meta-analysis. PLoS One 2015; 10 (08) : e0135267 . DOI: 10.1371/journal.pone.0135267. eCollection 2015
    CrossrefPubMedSearch in Google Scholar
  • 61 Mattarozzi K, Casini F, Baldin E. et al. Assessing subjective quality of life domains after multiple sclerosis diagnosis disclosure. Health Expect 2016; 19 (02) : 437-447
    CrossrefPubMedSearch in Google Scholar
  • 62 Windgassen K. Schizophreniebehandlung aus der Sicht des Patienten: Untersuchungen des Behandlungsverlaufes und der neuroleptischen Therapie unter pathischem Aspekt. Springer-Verlag, 2013
    PubMed
  • 63 Heinken J. Lebensqualitäts-Konzepte: Chancen und Grenzen: Lebensqualität und Patientennutzen – Konsequenzen für die Nutzenbewertung. Frankfurter Forum: Diskurse 2016; 14: 28-37
    PubMedSearch in Google Scholar