背景：临床医生在精神分裂症的药物治疗中坚持指南建议对于良好的患者预后很重要。评估处方是否遵循精神分裂症药物治疗指南，我们最近开发了多个质量指标的汇总指标:个体适合度评分(IFS).目前尚不清楚对指南的依从性是否与患者预后有关。这里,我们调查了精神分裂症患者IFS值与精神病性症状之间的相关性.
方法：我们评估了47例难治性精神分裂症（TRS）患者和353例非TRS患者（共n=400）使用IFS的患者当前处方是否符合指南建议，分别。IFS与总分之间的相关性以及阳性和阴性综合征量表（PANSS）的五个子量表上的得分。此外，我们在一些患者(n=77)中探讨了IFS值在2年以上的纵向变化与精神病性症状变化之间的相关性.
结果：我们发现整个精神分裂症患者的IFS与PANSS总分之间存在显着负相关（β=-0.18，p=9.80×10-5）。在非TRS患者（Spearman’srho=-0.15，p=4.40×10-3）和TRS患者（rho=-0.37，p=0.011）中，IFS与PANSS总分呈显著负相关，分别。IFS与几个因素也呈显著和名义上的负相关，如负面和压抑因素，在非TRS患者和TRS患者中，分别为(p<0.05)。此外，IFS值的变化与PANSS总分以及阳性和抑郁因子得分的变化呈负相关(p<0.05).
结论：这些研究结果表明，为提高临床医生对精神分裂症药物治疗指南建议的依从性，根据IFS的评估，可能会导致精神分裂症患者更好的结果。
Clinician adherence to
guideline recommendations in the pharmacological therapy of schizophrenia is important for favorable patient outcomes. To evaluate whether prescriptions followed the
guidelines for pharmacological therapy of schizophrenia, we recently developed a summary indicator of multiple quality indicators: the individual fitness score (IFS). It is unclear whether adherence to the
guidelines is related to patient outcomes. Here, we investigated correlations between the IFS values and psychotic symptoms in patients with schizophrenia.
We assessed whether patients\' current prescriptions adhered to the
guideline recommendations using the IFS in 47 patients with treatment-resistant schizophrenia (TRS) and 353 patients with non-TRS (total n = 400), respectively. We investigated correlations between the IFS and total scores and scores on the 5 subscales of the Positive and Negative Syndrome Scale (PANSS). Furthermore, we explored correlations between over 2-year longitudinal changes in IFS values and changes in psychotic symptoms in some patients (n = 77).
We found significant negative correlation between the IFS and PANSS total score in all patients with schizophrenia (β = -0.18, P = 9.80 × 10-5). The IFS was significantly and nominally negatively correlated with the PANSS total score in patients with non-TRS (Spearman\'s rho = -0.15, P = 4.40 × 10-3) and patients with TRS (rho = -0.37, P = .011), respectively. The IFS was also significantly and nominally negatively correlated with several factors, such as the negative and depressed factors, in patients with non-TRS and patients with TRS, respectively (P < .05). Furthermore, the change in IFS values was marginally negatively correlated with the changes in PANSS total scores and scores on the positive and depressed factors (P < .05).
These findings suggest that efforts to improve clinician adherence to
guideline recommendations for pharmacological therapy of schizophrenia, as assessed by the IFS, may lead to better outcomes in patients with schizophrenia.
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