Engelsk titel: Self-reported treatment adherence among psychiatric in- and outpatients
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Författare:
Karpov, Boris
;
Joffe, Grigori
;
Aaltonen, Kari
;
Oksanen, Jorma
;
Suominen, Kirsi
;
Melartin, Tarja
;
Baryshnikov, Ilya
;
Koivisto, Maaria
;
Heikkinen, Martti
;
Isometsä, Erkki T
Email: boris.karpov@hus.fi
Språk: Eng
Antal referenser: 52
Dokumenttyp:
Artikel
UI-nummer: 19010326
Sammanfattning
Background: Poor adherence to psychiatric treatment is a common clinical problem, leading to unfavourable treatment outcome and increased healthcare costs.
Aim: The aim of this study was to investigate the self-reported adherence and attitudes to outpatient visits and pharmacotherapy in specialized care psychiatric patients.
Methods: Within the Helsinki University Psychiatric Consortium (HUPC) pilot study, in- and outpatients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) were surveyed about their adherence and attitudes towards outpatient visits and pharmacotherapy. Correlates of self-reported adherence to outpatient and drug treatment were investigated using regression analysis.
Results: The majority (78.5%) of patients reported having attended outpatient visits regularly or only partly irregularly. Most patients (79.2%) also reported regular use of pharmacotherapy. Self-reported non-adherence to preceding outpatient visits was consistently and significantly more common among inpatients than outpatients across all diagnostic groups (p < .001). Across all groups, hospital setting was the strongest independent correlate of poor adherence to outpatient visits (SSA β = –2.418, BD β = –3.417, DD β = –2.766; p < .001 in all). Another independent correlate of non-adherence was substance use disorder (SSA β = –1.555, p = .001; BD β = –1.535, p = .006; DD β = –2.258, p < .000). No other socio-demographic or clinical factor was significantly associated with poor adherence in multivariate regression models.
Conclusions: Irrespective of diagnosis, self-reported adherence to outpatient care among patients with schizophrenia or schizoaffective disorder, bipolar disorder, and depression is associated strongly with two factors: hospital setting and substance use disorders. Thus, detection of adherence problems among former inpatients and recognition and treatment of substance misuse are important to ensure proper outpatient care.