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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

Isabelle Gasquet ,
Stéphanie Tcherny-Lessenot ,
Jean-Pierre Lepine  and
Bruno Falissard
Isabelle Gasquet
Affiliation:
Instituto Nacional de Salud e Investigación Médica-U669 (Grupo de Innovación de París-Sur en Metodología de Salud Mental Adolescente), Maison des Adolescents, Cochin Hospital, París, Francia Dirección de Política Médica, Asistencia Pública-Hospitales de París, París, Francia
Stéphanie Tcherny-Lessenot
Affiliation:
cLilly France, Suresnes, Francia
Jean-Pierre Lepine
Affiliation:
Departamento de Psiquiatría, Hospital Fernand Widal, Asistencia Pública-Hospitales de París, París, Francia
Bruno Falissard
Affiliation:
Instituto Nacional de Salud e Investigación Médica-U669 (Grupo de Innovación de París-Sur en Metodología de Salud Mental Adolescente), Maison des Adolescents, Cochin Hospital, París, Francia
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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

Satisfacciόn del pacienteEsquizofreniaPsicometríaCalidad de vidaCumplimiento del pacienteAgentes antipsicόticos
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 14 , Issue 4 , May 2007 , pp. 191 - 199
Copyright
Copyright © European Psychiatric Association 2007

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