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Article contents
Satisfacciόn del paciente con los medicamentos psicotropos: sensibilidad al cambio y relaciόn con el estado clínico, la calidad de vida, el cumplimiento y la efectividad del tratamiento. Resultados de un estudio nacional prospectivo de 6 meses
Published online by Cambridge University Press: 12 May 2020
Resumen
Objetivo
Se analizό las relaciones entre el psicotropo (PSP), el estado clínicos, la calidad de vida (CdV), el cumplimiento del tratamiento y el tipo de antipsicόtico para ver si la satisfaccion del paciente (SP) con el PSP se podía utilizar como variable de evoluciόn orientada al paciente en la evaluaciόn de los medicamentos PSP en los estudios epidemiolόgicos clinicos. Se evaluaron también elementos de validaciόn de los PSP.
Metodo
En un estudio prospectivo de 6 meses, se seleccionó a 933 pacientes ambulatorios esquizofrénicos que iniciaron un tratamiento antipsicόtico o lo cambiaron. Los psiquiatras cumplimentaron un cuestionario con las cinco escalas de la CGI-SCH (positiva, negativa, cognitiva, depresiva y global) e informacion sobre la hospitalizaciόn, el cumplimiento y variables de la prescripciόn. Los pacientes respondieron a un cuestionario con informaciόn de PSP, escalas de EuroCdV, la funciόn sexual y variables de cumplimiento.
Resultados
Se obtuvo un modelo de ecuaciones estructurales satisfactorio que mostraba relaciones significativas de PSP/cumplimiento (coef. = 0,16), CdV/PSP (coef. = 0,37), estado clinico/CdV (coef. = 0,61), estado cliníco/cumplimiento (coef. = 0,09). Los pacientes que recibieron olanzapina estaban más satisfechos que los que recibieron otros antipsicόticos atípicos (coef. = 0,12) y tenían un estado clínico mejor que los pacientes tratados con antipsicόticos típicos (coef. = 0,08). La evoluciόn del PSP se relacionaba con el estado clínico, la CdV y la continuaciόn del tratamiento (todas las P < 0,001). La sensibilidad al cambio del PSP era moderada (tamano del efecto = 0,2).
Conclusiόn
Los PSP produjeron resultados uniformes en relaciόn con los criterios de valoraciόn validados. Sin embargo, una medida de un elemento individual no era lo suficientemente sensible al cambio. Se necesitan cuestionarios multi-elemento que evalύen dimensiones diferentes.
Keywords
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- Artículo original
- Information
- Copyright
- Copyright © European Psychiatric Association 2007
References
Albrecht, G, Hoogstraten, J. Satisfaction as a determinant of compliance. Community Dent Oral Epidemiol 1998;26:139–46.CrossRefGoogle ScholarPubMed
Atkinson, M, Sinha, A, Hass, S, Colman, S, Kumar, R, Brod, M, et al. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes 2004;2:12.CrossRefGoogle Scholar
Awad, A, Voruganti, L. Intervention research in psychosis: issues related to the assessment of quality of life. Schiz Bull 2000;26:557–64.CrossRefGoogle ScholarPubMed
Awad, AG. Subjective response to neuroleptics in schizophrenia. Schizophr Bull 1993;19:609–18.CrossRefGoogle Scholar
Awad, AG, Voroganti, LN. Quality of life and new antipsychotics in schizophrenia. Are patients better off? Int J Soc Psychiatry 1999;45:268–75.CrossRefGoogle ScholarPubMed
Babiker, IE, Thome, P. Do psychiatric patients know what is good for them? J R Soc Med 1993;86:28–30.Google Scholar
Baker, L, Zucker, PJ, Gross, MJ. Using client satisfaction surveys to evaluate and improve services in locked and unlocked adult inpatient facilities. J Behav Health Serv Res 1998;25:51–63.CrossRefGoogle ScholarPubMed
Barker, DA, Shergill, SS, Higginson, I, Orrell, MW. Patients’ views towards care received from psychiatrists. Br J Psychiatry 1996;168:641–6.CrossRefGoogle ScholarPubMed
Bosnjak, S, Radulovic, S, Neskovic-Konstantinovic, Z, Mitrovic, L. Patient statement of satisfaction with antiemetic treatment is related to quality of life. Am J Clin Oncol 2000;23:575–8.CrossRefGoogle ScholarPubMed
Bradley, C, Lewis, KS. Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes. Diabet Med 1990;7:445–51.CrossRefGoogle ScholarPubMed
Bradley, CP. Uncomfortable prescribing decisions: a critical incident study. BMJ 1992;304:294–6.CrossRefGoogle ScholarPubMed
Bredart, A, Razavi, D, Robertson, C, Brignone, S, Fonzo, D, Petit, JY, et al. Timing of patient satisfaction assessment: effect on question- * naire acceptability, completeness of data, reliability and variability of scores. Patient Educ Couns 2002;46:131–6.CrossRefGoogle Scholar
Britten, N. Patients’ demands for prescriptions in primary care. BMJ 1995;310:1084–5.CrossRefGoogle ScholarPubMed
Britten, N, Ukoumunne, O. The influence of patients’ hopes of receiving a prescription on doctors’ perceptions and the decision to prescribe: a questionnaire survey. BMJ 1997;315:1506–10.CrossRefGoogle ScholarPubMed
Brody, DS, Miller, SM, Lemman, CE, Smith, DG, Caputo, GC. Patient perception of involvement in medical care: relationship to illness attitudes and outcomes. J Gen Intem Med 1989;4:506–11.CrossRefGoogle ScholarPubMed
Ceballos Hemansanz, MA, Sanchez Roy, R, Cano Orgaz, A, Lopez-Gil, A. Migraine treatment patterns and patient satisfaction with prior therapy: A substudy of a multicenter trial of rizatriptan effectiveness. Clin Ther 2003;25:2053–69.CrossRefGoogle Scholar
Clotet, B, Carmena, J, Pulido, F, Luque, I, Rodriguez-Alcantara, F. Adherence, quality of life, and general satisfaction with co-fommulated zidovudine, lamivudine, and abacavir on antiretroviral-experienced patients. HIV Clin Triais 2004;5:33–9.Google ScholarPubMed
Cramer, J, Rosenheck, R, Xu, W, Thomas, J, Henderson, W, Charney, D. Quality of life in schizophrenia: a comparison of instruments. Schiz Bull 2000;26:659–66.CrossRefGoogle ScholarPubMed
Day, JC, Bentall, RP, Roberts, C, Randall, F, Rogers, A, Cattell, D, et al. Attitudes toward antipsychotic medication: the impact of clinical variables and relationships with health professionals. Arch Gen Psychiatry 2005;62:717–24.CrossRefGoogle ScholarPubMed
Day, JC, Bentall, RP, Warner, S. Schizophrenic patients’ experiences of neuroleptic medication: a Q-methodological investigation. Acta Psychiatr Scand 1996;93:397–402.CrossRefGoogle ScholarPubMed
de Haan, L, Weisfelt, M, Dingemans, PM, Linszen, DH, Wouters, L. Psychometric properties of the Subjective Well-Being Under Neuroleptics scale and the Subjective Deficit Syndrome Scale. Psychopharmacology (Berl) 2002;162:24–8.CrossRefGoogle ScholarPubMed
Deyo, RA, Inui, TS. Dropouts and broken appointments. A literature review and agenda for future research. Med Care 1980;18:1146–57.CrossRefGoogle ScholarPubMed
Diamond, R. Drugs and the quality of life: the patient's point of view. J Clin Psychiatry 1985;46:29–35.Google ScholarPubMed
Donabedian, A. The quality of care How can it be assessed? JAMA 1988;260:1743–8.CrossRefGoogle ScholarPubMed
Doughty, J, Baker, GA, Jacoby, A, Lavaud, V. Compliance and satisfaction with switching from an immediate-release to sustained-release formulation o f valproate in people with epilepsy. Epilepsy Behav 2003;4:710–6.CrossRefGoogle Scholar
Druss, BG, Rosenheck, RA, Stolar, M. Patient satisfaction and administrative measures as indicators of the quality of mental health care. Psychiatr Serv 1999;50:1053–8.CrossRefGoogle ScholarPubMed
Falissard, B. Structurer des relations. In: Masson, editor, editor. Mesurer la subjéctivité en senté. Perpective méthodologique et statistique. Paris ; 2001. p.131–41.Google Scholar
Gaite, L, Vazquez-Barquero, J, Arrizabalaga, A, Schene, A, Welcher, B, Thornicroft, G, et al. Quality of life in schizophrenia: development, reliability and internal consistency of the Lancashire Quality of Life Profile-European Version: Epsilon study 8. Br J Psychiatry 2000;177:s49–54.CrossRefGoogle Scholar
Gonzales, R, Steiner, JF, Maselli, J, Lum, A, Barrett, PH Jr. Impact of reducing antibiotic prescribing for acute bronchitis on patient satisfaction. Eff Clin Pract 2001;4:105–11.Google ScholarPubMed
Haro, JM, Edgell, ET, Jones, PB, Alonso, J, Gavart, S, Gregor, KJ, et al. The European Schizophrenia Outpatient Health Outcomes (SOHO) study: rationale, methods and recruitment. Acta Psychiatr Scand 2003;107:222–32.CrossRefGoogle ScholarPubMed
Haro, JM, Kamath, SA, Ochoa, S, Novick, D, Rele, K, Fargas, A, et al. The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand 2003;Suppl: 16-23.CrossRefGoogle Scholar
Himmel, W, Lippert-Urbanke, E, Kochen, MM. Are patients more satishied when they receive a prescription? The effect of patient expectations in general practice. Scand J Prim Health Care 1997;15:118–22.CrossRefGoogle ScholarPubMed
Hogan, TP, Awad, AG. Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychol Med 1992;22:347–52.CrossRefGoogle ScholarPubMed
Hogan, TP, Awad, AG, Eastwood, R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med 1983;13:177–83.CrossRefGoogle ScholarPubMed
Holcomb, WR, Parker, JC, Leong, GB, Thiele, J, Higdon, J. Customer satisfaction and self-reported treatment outcomes among psychiatric inpatients. Psychiatr Serv 1998;49:929–34.CrossRefGoogle ScholarPubMed
Kampman, O, Lehtinen, K, Lassila, V, Leinonen, E, Poutanen, O, Koivisto, A. Altitudes towards neuroleptic treatment: reliability and validity of the attitudes towards neuroleptic treatment (ANT) questionnaire. Schizophr Res 2000;45:223–34.CrossRefGoogle Scholar
Keefe, RS, Seidman, LJ, Christensen, BK, Hamer, RM, Sharma, T, Sitskoom, MM, et al. Comparative effect of atypical and conventional antipsychotic drugs on neurocognition in first-episode psychosis: a randomized, double-blind trial of olanzapine versus low doses of haloperidol. Am J Psychiatry 2004;161:985–95.CrossRefGoogle ScholarPubMed
Lambert, MF, Wood, J. Incorporating patient preferences into randomized triais. J Clin Epidemiol 2000;53:163–6.CrossRefGoogle Scholar
Lenert, LA, Ziegler, J, Lee, T, Sommi, R, Mahmoud, R. Differences in health values among patients, family members, and providers for outcomes in schizophrenia. Med Care 2000 ,38:1011–21.CrossRefGoogle Scholar
Leucht, S, Wahlbeck, K, Hamann, J, Kissling, W. New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis. Lancet 2003;361:1581–9.CrossRefGoogle ScholarPubMed
Loehlin, JC. In: Mahwah, NJ, editor.Latent variable models an introduction to factor, path, and structural equation analysis. L. Erlbaum Associates ; 2004. p.317.CrossRefGoogle Scholar
Longford, NT. Selection bias and treatment heterogeneity in clinical triais. Stat Med 1999;18:1467–74.3.0.CO;2-H>CrossRefGoogle Scholar
Malm, U, Lewander, T. Consumer satisfaction in schizophrenia. A 2- year randomized controlled study of two community-based treatment programs. Nord J Psychiatry 2001;55(Suppl 44):91–6.Google ScholarPubMed
Naber, D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol 1995;10(Suppl 3):133–8.Google ScholarPubMed
Priebe, S, Gruyters, T. Patients’ assessment of treatment predicting out-come. Schizophr Bull 1995;21:87–94.CrossRefGoogle Scholar
Priebe, S, Kaiser, W, Huxley, PJ, Roder-Wanner, W, Rudolf, H. Do different subjective evaluation criteria reflect distinct constructs? J Nerv Ment Dis 1998;186:385–92.CrossRefGoogle ScholarPubMed
Prieto, L, Novick, D, Sacristan, JA, Edgell, ET, Alonso, J. A Rasch model analysis to test the cross-cultural validity of the EuroQoL-SD in the Schizophrenia Outpatient Health Outcomes Study. Acta Psychiatr Scand 2003;Suppl: 24-9.CrossRefGoogle Scholar
Roghmann, KJ, Hengst, A, Zastowny, TR. Satisfaction with medical care: its measurement and relation to utilization. Med Care 1979;17:461–79.CrossRefGoogle Scholar
Rohland, BM, Langbehn, DR, Robrer, JE. Relationship between Service effectiveness and satisfaction among persons receiving Medicaid mental health services. Psychiatr Serv 2000;51:248–50.CrossRefGoogle ScholarPubMed
Shapiro, E. Injudicious antibiotic use: an unforeseen consequence of the emphasis on patient satisfaction? Clin Ther 2002;24:197–204.CrossRefGoogle ScholarPubMed
Sitzia, J, Wood, N. Patient satisfaction: a review of issues and concepts. Soc Sci Med 1997;45:1829–43.CrossRefGoogle ScholarPubMed
Thompson, K, Kulkami, J, Sergejew, AA. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr Res 2000;42:241–7.CrossRefGoogle ScholarPubMed
Voruganti, L, Cortese, L, Owyeumi, L, Kotteda, V, Cemovsky, Z, Zirul, S, et al. Switching from conventional to novel antipsychotic drugs: results of a prospective naturalistic study. Schizophr Res 2002;57:201–8.CrossRefGoogle ScholarPubMed
Voruganti, L, Cortese, L, Oyewumi, L, Cemovsky, Z, Zirul, S, Awad, A. 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;43:135–45.CrossRefGoogle ScholarPubMed
Ware, JE Jr, Snyder, MK, Wright, WR, Davies, AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann 1983;6:247–63.CrossRefGoogle ScholarPubMed
Weiden, PJ, Mackell, JA, McDonnell, DD. Obesity as a risk factor for antipsychotic noncompliance. Schizophr Res 2004;66:51–7.CrossRefGoogle ScholarPubMed
Williams, B. Patient satisfaction: a valid concept? Soc Sci Med 1994;38:509–16.CrossRefGoogle ScholarPubMed
Winefield, HR, Murrell, TG, Clifford, J. Process and outcomes in general practice consultations: problems in defining high quality care. Soc Sci Med 1995;41:969–75.CrossRefGoogle ScholarPubMed
Witthaus, E, Stewart, J, Bradley, C. Treatment satisfaction and psychological well-being with insulin glargine compared with NPH in patients with Type 1 diabetes. Diabet Med 2001;18:619–25.CrossRefGoogle ScholarPubMed