Zusammenfassung
Wirksame und gut verträgliche Psychopharmaka stellen die Basis der Behandlung schwerer psychischer Erkrankungen dar. Trotzdem liegen deren Adhärenzraten nach einem Jahr nur bei rund 50 %. Der Begriff Adhärenz betont die gemeinsame Verantwortung von Behandler und Patient für eine erfolgreiche Therapie. Die Gründe für Nicht-Adhärenz sind vielfältig und umfassen neben unzureichender Wirksamkeit und dem Auftreten von Nebenwirkungen der Psychopharmaka vor allem patientenspezifische Faktoren wie Selbststigmatisierung, fehlende soziale und familiäre Unterstützung, kognitive Defizite oder Substanzgebrauch. Zur Verbesserung der Adhärenz ist es für Behandler und Patient wichtig, alle Gründe, die für oder gegen eine Medikamenteneinnahme sprechen, zu verstehen, bevor eine gemeinsame Entscheidung über die psychopharmakologische Langzeitbehandlung getroffen wird. Eine positive Adhärenzeinstellung wird entscheidend dadurch geprägt, ob die Medikamenteneinnahme dem Patienten hilft, seine persönlichen Ziele zu erreichen.
Summary
Effective psychopharmacological medication with good tolerability represents the cornerstone of treatment for severe mental illness; however, the 1-year adherence rates are only approximately 50 %. The term adherence emphasizes the collaborative responsibility of the clinician and the patient for a positive treatment outcome. Reasons for non-adherence are manifold and include patient-specific factors, such as self-stigmatization, lack of social and familial support, cognitive impairment and substance use besides insufficient effectiveness and the occurrence of side effects of the psychotropic drugs. To enhance adherence, both clinician and patient have to fully understand all the reasons for and against adherence to medication before a collaborative decision is made on future long-term treatment. A positive attitude towards medication critically depends on whether patients feel that the medication supports the attainment of the individual goals.
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Interessenkonflikt. R. Lencer und D. Korn geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Lencer, R., Korn, D. Adhärenz in der Psychopharmakologie. Nervenarzt 86, 637–648 (2015). https://doi.org/10.1007/s00115-015-4275-z
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DOI: https://doi.org/10.1007/s00115-015-4275-z