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지역사회에 거주하는 조현병 환자와 보호자들의 장기지속형 주사제 항정신병약물에 대한 선호도 조사

The Preference Survey for Long-Acting Injectable Antipsychotics of Community-Dwelling Patients with Schizophrenia and their Caregivers

윤탁|최용성|이남영|정인원|이융
대한조현병학회 (Korean Academy of Schizophrenia)|2013.04|대한조현병학회지 (Korean Journal of Schizophrenia Research)|제16권 제1호|pp. 14-24

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참고문헌

키워드

조현병SchizophreniaLong-acting injectable antipsychoticsCommunity mental health centers지역사회정신보건센터장기지속형 주사제
주제분류정신과학

초록

본 조사연구 결과에 의하면 지역사회의 환자 및 보호자들은 약물치료의 중요성을 잘 알고 있었으며 장기지속형 주사제에 대한 선호도는 의료기관을 대상으로 조사한 결과에서 보다 높게 나타났다. 장기지속형 주사제를 선호하는 환자들은 투여 간격이 1개월이라는 점과 치료효과에 대한 기대가 높았으며, 부작용에 대해서도 우려하고 있었다. 장기지속형 주사제를 거절하는 환자들은 주사 자체를 싫어하였으며 경구용 약물의 치료효과로 만족하고 있었으며 장기지속형 주사제의 높은 가격과 장기 지속 효과에 대한 염려를 하고 있었다. 장기지속형 주사제를 선호하는 보호자들도 1개월 간격의 투여방법을 선호하였으며 장기지속형 주사제의 부작용과 낮은 임상적 효과를 우려하고 있었다. 장기지속형 주사제를 선호하지 않는 보호자들은 경구용 약물에 만족하고 있었다. 특히 보호자들 중에서 그들의 환자가 입원 또는 약물 중단의 경험이 많은 경우에 장기지속형 주사제의 선호도가 높아서 보호자들이 환자들의 지속적인 약물 복용의 관리에 대한 부담감이 높다는 것을 의미하며 전체적으로 환자 및 보호자들 모두에서 환자의 지역사회 거주에 대한 의지가 높았다는 것을 확인할 수 있었다.

Abstract

Objective : The prescription rates of long-acting injectable (LAI) antipsychotics are very low around 1% in Korea. This study was aimed to explore the preference of LAIs in patients with schizophrenia, who are currently living in community, and their caregivers. Methods : The patients, diagnosed with schizophrenia by DSM-IV TR and were registered in the 31 mental health centers of Gyeonggi province and their caregivers were inquired the knowledge of the LAIs. The questionnaires contained information such as demographic characteristics, history of psychiatric treatment, and so on. Results : About 5,318 were registered in 31 community mental health centers of Gyeonggi province in February 2012. The questionnaires of 614 patients and 365 caregivers were gathered from 20 community mental health centers. The mean ages (±SD) of patients and caregivers were 41.9 (±10.2) and 62.2 (±13.4) years old, respectively. 272 patients (44.6%) had experienced the discontinuation of medications without doctor’s consent. 217 patients (35.9%) and 97 caregivers (27.1%) knew about the LAIs. The preference rates for LAIs were 35.2% and 46.8% for the patients and caregivers, respectively. Conclusion : There is still huge discrepancy between the preference and the real prescriptions of LAIs in community-dwelling patients and their caregivers, much higher than in those of hospital settings. This study suggests that both patients and caregivers registered in the community mental health centers have a strong commitment to live in the community. The obstacles against the benefits of LAIs need to be resolved.

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