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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2016, Number 6

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Salud Mental 2016; 39 (6)

Adherencia a la medicación antipsicótica en pacientes indígenas con esquizofrenia

Caqueo-Urízar A, Urzúa MA, Miranda-Castillo C, Irarrázaval M

Language: Spanish
References: 62
Page: 303-310
PDF size: 195.80 Kb.


ABSTRACT

Introduction Non-adherence to antipsychotic medication remains a complex problem in the treatment of schizophrenia patients, especially in indigenous population.
Objective The aim of the study was to assess the differences in drug adherence, measured by the attitude towards the antipsychotics among Aymara and Non-Aymara patients with schizophrenia.
Method The sample consisted of patients receiving treatment in the Mental Health Public Services in Bolivia (32.8%), Peru (33.6%) and Chile (33.6%). We used the Drug Attitude Inventory (DAI-10); the Barnes Akathisia Scale (BAS), as a measure of side effects, and the Positive and Negative Syndrome Scale (PANSS) to assess the severity of the disorder.
Results The findings showed that Aymara patients present less adherence than Non-Aymara people; however, these differences were not significant (t = 1.29; p = 0.19). The severity of the disorder, as well as the age, showed a significant association with adherence, revealing that younger patients and with greater symptoms presented a more negative attitude toward the drugs.
Discussion and conclusion The lack of significant differences between the groups responds to three possible reasons: 1. This sample of indigenous patients is integrated on Mental Health Services that offer a clear biomedical approach where drug therapy is the primary treatment. 2. It is possible that these indigenous patients are changing their conception of mental disorder, and 3. A significant number of families have migrated to urban areas. These migratory dynamics have promoted the loss of traditions and customs of the ethnic group, which gradually adopts new and intercultural lifestyles. Professionals should be warned about applying stereotypes regarding the relationship between ethnicity and antipsychotics.


REFERENCES

  1. Gilmer TP, Ojeda VD, Barrio C, Fuentes D et al. Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited english proficiency. Psych Serv 2009;60(2):175-182.

  2. Nitzan U, Bukobza G, Aviram, S, Lev-Ran S et al. Rebelliousness in patients suffering from schizophrenia-spectrum disorders - a possible predictor of adherence. Psychiatr Res 2013;209:297–301.

  3. Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997;23:637–651.

  4. Jeste SD, Patterson, TL, Palmer BW, Dolder CR et al. Cognitive predictors of medication adherence among middle-aged and older outpatients with schizophrenia. Schizophr Res 2003;63:49–58.

  5. Lacro JP, Dunn LB, Dolder CR, Leckband SG et al. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63(10):892–909.

  6. Razali MS, Yahya H. Compliance with treatment in schizophrenia: a drug intervention program in a developing country. Acta Psychiatr Scand 1995;91:331–335.

  7. Sun SX, Liu GG, Christensen DB, Fu AZ. Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin 2007; 23:2305–2312.

  8. Velligan DI, Weiden PJ, Sajatovic M, Scott J et al. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry 2009;70(4):S1–S46.

  9. Young JL, Zonana HV, Shepler L. Medication noncompliance in schizophrenia: codification and update. Bull Am Acad Psychiatry Law 1986;14:105–122.

  10. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS et al. Clinical antipsychotic trials of intervention effectiveness (CATIE) investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005;353(12):1209-1223.

  11. World Health Organization. Adherence to long-term therapies evidence for action. World Health Organization. 2003;107–114. http://www. who.int/bookorders/anglais/detart1.isp?sesslan=1& codlan=1&codcol= 15&codcch-526. Accessed October 19, 2010.

  12. Dilla T, Valladares A, Lizán L, Sacristán JA. Adherencia y persistencia terapéutica: causas, consecuencias y estrategias de mejora. Aten Primaria 2009;41:342–348.

  13. López San Román A. Treatment adhesion, treatment adherence or treatment compliance? Rev Clin Esp 2006;206:414.

  14. Medina E, Salvà J, Ampudia R, Maurino J et al. Short-term clinical stability and lack of insight are associated with a negative attitude towards antipsychotic treatment at discharge in patients with schizophrenia and bipolar disorder. Patient Prefer Adherence 2012;6:623–629.

  15. Fleischhacker WW, Oehl MA, Hummer M. Factors influencing compliance in schizophrenia patients. J Clin Psychiatry 2003;64(16):10–13.

  16. Morken G, Widen JH, Grawe RW. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia. BMC Psychiatry 2008;8:32-34.

  17. Borras L, Mohr S, Brandt PY, Gilliéron C et al. Religious beliefs in schizophrenia: Their relevance for adherence to treatment. Schizophr Bull 2007;33(5):1238-1246.

  18. Eaddy M, Grogg A, Locklear J. Assessment of compliance with antipsychotic treatment and resource utilization in a Medicaid population. Clin Ther 2005;27:263–272.

  19. Robinson D, Woerner MG, Alvir JM et al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 1999;56:241–247.

  20. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophr Bull 1995;21:419–429.

  21. Czobor P, Van Dorn RA, Citrome L, Kahn RS et al. Treatment adherence in schizophrenia: a patient-level meta-analysis of combined CATIE and EUFEST studies. Eur Neuropsychopharmacol 2015; 25(8):1158- 1166.

  22. Opolka, JL, Rascati KL, Brown CM, Gibson PJ. Role of ethnicity in predicting antipsychotic medication adherence. Ann Pharmacother 2003a;37(5):625-630.

  23. Opolka JL, Rascati KL, Brown, CM, Barner JC et al. Ethnic differences in use of antipsychotic medication among Texas medicaid clients with schizophrenia. J Clin Psychiatry 2003b;64(6):635-639.

  24. Diaz E, Woods SW, Rosenheck R. Effects of Ethnicity on Psychotropic Medications Adherence. Community Ment Health J 2005;41:521–537.

  25. Gilmer TP, Dolder CR, Lacro JP et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry 2004;161:692–699.

  26. Valencia M, Rascon ML, Juarez F, Murow E. A psychosocial skills training approach in Mexican out-patients with schizophrenia. Psychol Med 2007;37(10):1393-1402.

  27. Valencia M, Rascon ML, Juarez F, Escamilla R et al. Application in Mexico of psychosocial rehabilitation with schizophrenia patients. Psychiatry 2010;73(3):248-263.

  28. Valencia M, Juarez F, Ortega H. Integrated treatment to achieve functional recovery for first-episode psychosis. Schizophr Res Treatment 2012; doi:10.1155/2012/962371

  29. Valencia M, Fresan A, Juárez F, Escamilla R et al. The beneficial effects of combining pharmacological and psychosocial treatment on remission and functional outcome in outpatients with schizophrenia. J Psychiatric Research 2013;47(12):1886-1892.

  30. Valencia M, Moriana JA, Kopelowicz A, Lopez SR et al. Social-Skills training for Spanish-speaking persons with schizophrenia: Experiences from Latin America, Spain, and the United States. Am J Psychiatr Rehabil 2015;18(3):209-246.

  31. Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. J Psychol Med 1983;13:177–183.

  32. Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry 1989;154:672-676.

  33. Kay SR, Fiszbein A, Opler L. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-276.

  34. Köster G. Los Aymaras: Características demográficas de un grupo étnico indígena antiguo en los Andes centrales. En: Van den Berg H, Schiffers N (eds.). La cosmovisión Aymara La Paz, Bolivia: UCB⁄ Hisbol; 1992; pp. 81-111.

  35. Van Kessel J. La cosmovisión Aymara. En: Hidalgo J, Schiappacasse F, Niemeyer F, Aldunate C, Mege P. (eds.). Etnografía: Sociedades indígenas contemporáneas y su ideología. Santiago, Chile: Editorial Andrés Bello; 1996; pp:169-187.

  36. Gundermann H. Las organizaciones étnicas y el discurso de la identidad en el norte de Chile, 1980-2000. Estudios Atacameños 2000;19:75-91.

  37. Zapata C. Memoria e historia: El proyecto de una identidad colectiva entre los aymaras de Chile. Chungara 2007;39:171-183.

  38. De Munter K. Tejiendo reciprocidades: John Murra y el contextualizar entre los aymara contemporáneos en Chungara. Chungara 2010;4:243- 251.

  39. Juntuma de Chapiquiña. Medicina indígena y alimentación tradicional del pueblo de Chapiquiña. Trabajo fundando por el Programa de Salud y Pueblos Indígenas (PEPSI); 2002.

  40. Laks, Jordana. Reflexiones sobre la tristeza y la preocupación en las personas Aymara de Putre, Chile. Independent Study Project (ISP) Collection. Paper 1054; 2011. http://digitalcollections.sit.edu/isp_collection/ 1054. Accessed March 19, 2013.

  41. World Health Organization. ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Ginebra, Suiza: World Health Organization; 1992.

  42. Nielsen RE, Lindström E, Nielsen J, Levander S. DAI-10 is as good as DAI-30 in schizophrenia. Eur Neuropsychopharmacol 2012;22(10):747- 750.

  43. Saleem F, Hassali MA, Shafie AA, Awad AG et al. Association between knowledge and drug adherence in patients with hypertension in Quetta, Pakistan. Trop J Pharm Res 2011;10:125-132.

  44. Ramírez Barreto F, Robles García R, Salazar Alvarado V, Páez Agraz F. Evaluación de actitudes al medicamento en pacientes con esquizofrenia: propiedades psicométricas de la versión en español del DAI. Actas Esp Psiquiatr 2004;32(3):138-142.

  45. Peralta V, Cuesta MJ. Validación de la Escala de los Síndromes Positivo y Negativo (PANSS) en una muestra de esquizofrénicos españoles. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1994;22(4):171-177.

  46. Fresán A, De la Fuente-Sandoval C, Loyzaga C, García-Anaya, M et al. A forced five-dimensional factor analysis and concurrent validity of the Positive and Negative Syndrome Scale in Mexican schizophrenic patients. Schizophr Res 2005;72:123–129.

  47. Markkula N, Alvarado R, Minoletti A. Adherence to guidelines and treatment compliance in the Chilean national program for first-episode schizophrenia. Psychiatr Serv 2011;62(12):1463-1469.

  48. Caqueo-Urízar A, Breslau J, Gilman S. Beliefs about the causes of schizophrenia among Aymara and non-Aymara patients and their primary caregivers in the Central-Southern Andes. Int J Soc Psychiatry 2015;61(1):82–91.

  49. Gundermann H. Acerca de cómo los aymaras aprendieron el castellano (terminando por olvidar el aymara). Estudios Atacameños 1997;12:89- 104.

  50. Gavilán V, Vigueras P, Carrasco A, Cabezas R et al. Pautas de crianza Aymara. Significaciones, actitudes y prácticas de familias Aymara en relación a la crianza y cuidado infantil de los niños y niñas desde la gestación hasta los diez. Chile: Centro de Investigaciones para el Desarrollo del Hombre en el Desierto, Universidad Arturo Prat, Chile; 2006.

  51. Tsai JK, Lin WK, Lung FW. Social interaction and drug attitude effectiveness in patients with schizophrenia. Psychiatr Q 2011;82(4):343-51.

  52. Yang J, Ko Y-H, Paik J-W et al. Symptom severity and attitudes toward medication: Impacts on adherence in outpatients with schizophrenia. Schizophrenia Res 2012;134(2-3):226-231.

  53. Gaebel W, Riesbeck M, von WM, Burns T et al. Drug attitude as Predictor for effectiveness in first-episode schizophrenia: results of an open randomized trial (EUFEST). Eur Neuropsychopharmacol 2010;20:310–316.

  54. Mohamed S, Rosenheck R, McEvoy J et al. Crosssectional and longitudinal relationships between insight and attitudes toward medication and clinical outcomes in chronic schizophrenia. Schizophr Bull 2009;35(2):336-346.

  55. Nakonezny PA, Byerly MJ, Rush AJ. Electronic monitoring of antipsychotic medication adherence in outpatients with schizophrenia or schizoaffective disorder: an empirical evaluation of its reliability and predictive validity. Psychiatry Res 2008;157:259–263.

  56. Sellwood W, Tarrier N, Quinn J et al. The family and compliance in schizophrenia: the influence of clinical variables, relatives’ knowledge and expressed emotion. Psychol Med 2003;33:91–96.

  57. Freudenreich O, Cather C, Evins A, Henderson D et al. Attitudes of schizophrenia outpatients toward psychiatric medications: relationship to clinical variables and insight. J Clin Psychiatry 2004;65:1372-6.

  58. Nosé M, Barbui C, Tansella M. How often do patients with psychosis fail to adhere to treatment programmes? A systematic review. Psychol Med 2003;33:1149–1160.

  59. Sajatovic M, Valenstein M, Blow F, Ganoczy D et al. Treatment adherence with lithium and anticonvulsant medications among patients with bipolar disorder. Psychiatr Serv 2007;58(6):855-863.

  60. Perkins DO, Johnson JL, Hamer RM, Zipursky RB et al. Predictors of antipsychotic medication adherence in patients recovering from a first psychotic episode. Schizophr Res 2006;83(1):53–63.

  61. Perkins DO, Gu H, Weiden PJ, McEvoy JP et al. Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. J Clin Psychiatry 2008;69(1):106–113.

  62. Vassileva IV, Milanova VK. Attitudes toward antipsychotic medication, insight and psychopathology in outpatients with schizophrenia. Folia Med 2012;54(4):62-68.




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