门诊免费给药联合社区管理服务对稳定期精神分裂症患者精神症状及社会功能的影响

目的 探讨门诊免费给药联合社区管理服务对稳定期精神分裂症患者精神症状及社会功能的影响.方法 102例稳定期精神分裂症患者,其中50例患者(干预组)出院后给予抗精神病药物费用补助及社区管理服务,52例患者(对照组)出院后仅在门诊接受常规治疗,随访12个月.分别在入组时、治疗后3、6、9、12个月时采用简明精神病评定量表(BPRS)、社会功能缺陷筛选量表(SDSS)评价两组患者的精神症状及社会功能情况,采用药物依从性评定表评定患者治疗依从性;记录并对比两组随访期间医疗费用开支、工作收入情况.结果 两组患者BPRS、SDSS评分均随时间延长而降低(均P<0.05);在治疗9、12个月时,干预组BPRS、SDSS评分及药物治疗依从性均优于对照组(P<0.05);治疗12个月内,干预组复发率、再住院率、住院费用均低于对照组(P<0.05).结论 门诊免费给药联合社区管理服务模式能有效控制稳定期精神分裂症患者的精神症状,改善社会功能,提高药物治疗依从性,降低复发率、再住院率,减少再住院费用.

Effect of free outpatient drug supply combined with community management services on psychiatric symptoms and social function of patients with stable schizophrenia

Objective To explore the effect of free outpatient drug supply combined with community management services on the psychiatric symptoms and social function of patients with stable schizophrenia .Methods Of 120 patients with stable schizophrenia ,50 were given medicaid for antipsychotic drugs and community management services after discharge ( intervention group ) ,and another 52 were given conventional therapy in clinics after discharge (control group).The follow-up lasted for 12 months.The Brief Psychiatric Rating Scale ( BPRS) and Social Disability Screening Schedule ( SDSS ) were used to evaluate the psychiatric symptoms and social function of the patients in the two groups on admission ,at 3,6,9 and 12 months after treatment respectively ,and the Drug Compliance Assessment to patients′treatment compliance .The medical costs and incomes during the follow-up were recorded and compared between the two groups . Results BPRS and SDSS scores decreased over time in the two groups (all P<0.05).At 9 and 12 months after treatment,the medication compliance,BPRS and SDSS scores of the intervention group were superior to those of the control group (P<0.05).During 12 months after treatment,the recurrence rate,rehospitalization rate and hospitalization costs of the intervention group were lower than those of the control group(P<0.05).Conclusion The free outpatient drug supply combined with the model of community management services can effectively control the psychiatric symptoms of patients with stable schizophrenia ,improve the social function ,increase the medication compliance ,and reduce the recurrence rate ,rehospitalization rate and rehospitalization costs .