[원저] 6개월 이상 추적진료 도중 입원한 정신분열병 환자의 입원 전 항정신병 약물 순응도 및 유지 용량

Antipsychotic Compliance and Maintenance Dosage in Admitted Patients with Schizophrenia Who had Follewed Up Over 6 Months

Objective: This study was intended to investigate whether maintenance dosage has been enough for patients with schizophrenia to prevent relapse by examining antipsychotic medication compliance and maintenance dosage during 6 months prior to the admission. Methods : The study subjects were 552 patients with schizophrenia who were admitted to Asan Medical Center between March 2000 and August 2003. Of the 552, 142 patients' compliance of antipsychotic regimen and mean daily dosage was calculated by analyzing refill record for up to 6 months prior to the admission. The cumulative mean gap ratios (CMG : the number of days when medication was unavailable in relation to the total number of days) at 6 months were calculated. Improvement of CGI-severity score during the admission and mean daily dosage of antipsychotic regimen at the time of discharge was also investigated. Results : Of the readmitted patients, 37.1 % were totally non-compliant during 6 months prior to the admission. The CMG score of the patients who had been followed up over 6 months was 22.2%. Patients whose CMG score was less than 20 percent were 62.7 percent of the overall subjects. Their mean daily dosage of anti psychotics for 6 months prior to the admission was 265 mg/day CPZ-EQ, and the dosage of anti psychotics on discharge was 432 mg/day CPZ-EQ. After raising the dosage of anti psychotics, the CGI-S was improved by the average of -1.45. Conclusion: Despite the advancement of atypical anti psychotics, noncompliance to medication still remains a serious problem in relapse of schizophrenia. On the other hand, 62.7% of overall patients had experienced relapse of schizophrenia despite good compliance over 80 percent and maintenance dosage of 265 mg/day CPZEQ. Their symptoms could be relieved by raising the dosage of antipsychotics during the admission. Therefore, in those patients, the maintenance dosage of 265 mg/day CPZ-EQ was not enough to prevent relapse.