Wenn Arzneimittel nicht eingenommen werden - der Einfluss verschiedener Antipsychotika auf das Complianceverhalten schizophrener Patienten

Zusammenfassung

Der Erfolg einer Arzneimitteltherapie wird unter anderem bestimmt vom Ausmaß, in dem Patienten die verordneten Arzneimittel einnehmen. Chronisch kranke Patienten nehmen jedoch im Mittel lediglich die Hälfte der Arzneimittel wie verordnet ein. Besonders bei schizophrenen Patienten, die meist langjährig Antipsychotika einnehmen müssen, sind die Complianceraten niedrig. Bisher konnten nur wenige eindeutige Faktoren identifiziert werden, die zu Noncompliance führen oder das Complianceverhalten beeinflussen. Atypische Antipsychotika werden ebenso wie Depotformulierungen oft mit einer verbesserten Compliance in Zusammenhang gebracht. In unserer systematischen Literaturrecherche konnten wir keinen Beleg für den häufig beworbenen Unterschied in Complianceraten zwischen atypischen und typischen Antipsychotika finden. Der Einsatz von Depotpräparaten hat den Vorteil, dass noncompliante Patienten einfach identifizierbar sind und so Interventionen gezielt eingesetzt werden können.

Abstract

The effectiveness of pharmacotherapy partly depends on patients’ compliance. However noncompliance with pharmacotherapy occurs frequently. It is particularly a problem in diseases requiring long-term treatment. On average chronically ill patients only take about half of their medication as prescribed. Especially patients with chronic psychiatric diseases, such as schizophrenia, are known to have low compliance rates. Atypical antipsychotics or depot medication are believed to improve compliance. In our systematic literature review we identified ten studies analysing the differences in compliance rates between atypical and typical antipsychotics. However our analyses did not show a difference in compliance rates except for clozapine. The higher compliance rates for clozapine might be explained by the regular monitoring and thus frequent patient contact. A positive effect of depot antipsychotics on compliance could be explained by the easy detection of noncompliant patients.

Schlüsselwörter

Compliance - Schizophrenie - Antipsychotika - Arzneimitteltherapie - Arzneimittelsicherheit

Key words

compliance - schizophrenia - antipsychotic drugs - drug therapy - drug safety

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