Quantifying the Tolerability of Antipsychotic Treatment-Related Side Effects in Schizophrenia: A Survey Study of Patients and Caregiver Proxies.

IF 2 3区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Patient preference and adherence Pub Date : 2025-09-09 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S466742
Melissa Culhane Maravic, Kelly Birch, Anh Thy H Nguyen, Alicia Subasinghe, Elizabeth Stafford, Christopher Zacker
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引用次数: 0

Abstract

Background: Antipsychotic medications are considered the mainstay of treatment for schizophrenia. However, these medications are associated with a wide range of side effects, which may be tolerated differently by patients, and may impact initiation and continuation of treatment.

Purpose: This study aimed to assess the tolerability of antipsychotic medication side effects for patients with schizophrenia and understand how side effects may impact decisions to initiate and remain in treatment.

Methods: A cross-sectional survey was conducted with 200 people living with schizophrenia and 100 caregiver proxies for those with severe disease presentation. The survey utilized the Maximum Difference Scaling (MaxDiff) approach to quantify preferences and a direct elicitation survey to rank specific side effects. Descriptive analysis and statistical analyses were conducted to address the study objectives.

Results: Results indicated that extrapyramidal side effects such as pseudoparkinsonism and tardive dyskinesia, as well as feeling detached and memory and cognitive issues were ranked as the least tolerable. In contrast, side effects such as reduced interest in/enjoyment of sex, feeling tired or drowsy, and dry mouth were perceived as more tolerable. Caregivers' perspectives closely aligned with the care recipients' rankings, with an additional particular concern for high blood sugar that may lead to diabetes. Side effects such as pseudoparkinsonism, memory and cognitive problems, and weight gain were associated with unwillingness to initiate or continue an effective antipsychotic medication.

Conclusion: These findings highlight the importance of considering side effect profiles when selecting and discussing treatment options with patients. Side effects can potentially impact patients' willingness to start or switch medications, therefore, prescribing decisions should take into consideration patients' tolerance for potential adverse effects. Engaging patients and caregivers in treatment decisions can enhance shared decision-making and treatment satisfaction. Healthcare providers should consider these findings when prescribing antipsychotic medications to people living with schizophrenia.

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量化精神分裂症抗精神病治疗相关副作用的耐受性:一项对患者和护理代理的调查研究。
背景:抗精神病药物被认为是治疗精神分裂症的主要药物。然而,这些药物具有广泛的副作用,患者的耐受性可能不同,并可能影响治疗的开始和继续。目的:本研究旨在评估精神分裂症患者抗精神病药物副作用的耐受性,并了解副作用如何影响开始和继续治疗的决定。方法:对200名精神分裂症患者和100名有严重疾病表现的护理人员进行横断面调查。该调查利用最大差异缩放(MaxDiff)方法来量化偏好,并利用直接启发调查对特定副作用进行排名。进行了描述性分析和统计分析,以解决研究目标。结果:结果显示锥体外系副作用,如假性帕金森病和迟发性运动障碍,以及感觉疏离和记忆和认知问题被列为最不可容忍的。相比之下,诸如降低对性的兴趣/享受、感到疲倦或昏昏欲睡、口干等副作用被认为是可以忍受的。照护者的观点与接受照护者的排名密切相关,并特别关注可能导致糖尿病的高血糖。假性帕金森氏症、记忆和认知问题以及体重增加等副作用与不愿开始或继续有效的抗精神病药物有关。结论:这些发现强调了在与患者选择和讨论治疗方案时考虑副作用概况的重要性。副作用可能会影响患者开始或转换药物的意愿,因此,处方决定应考虑患者对潜在副作用的耐受性。让患者和护理人员参与治疗决策可以提高共同决策和治疗满意度。医疗保健提供者在给精神分裂症患者开抗精神病药物处方时应考虑这些发现。
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来源期刊
Patient preference and adherence
Patient preference and adherence MEDICINE, GENERAL & INTERNAL-
CiteScore
3.60
自引率
4.50%
发文量
354
审稿时长
6-12 weeks
期刊介绍: Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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