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18 2012


I


1990 .


1980 .


,

1960 .

1960-70 .

1950

1960

1990

2000

() -

Weiden et al. 1996;


Kane 2001;


: . .,%

I- , II-
, III ,
IV- , V-

, %



79,0%
77,0%

76,7%

75,0%
73,0%
71,0%
69,0%
67,0%
65,0%

14
72,0%

13
65,9%
63,8%

63,0%

61,7%

61,0%

60,1%

59,0%

59,6%

57,0%
55,0%
1993

1998

2000

, .



700

642,3

600
500
400

302,3
300

159,8

200
100

17,4

44,1

0
1

1-; 2- ; 3- ;
4- ( )
; 5-

()
;

;


(..
)
() (adherence):

(R.B. Haynes, 1979)
noncompliance adherence concordance ():



(
80% )
(2080% )

()
***
(
)

60%

> 20%

% ,


()

75%

80
70

50%

60
50
40

25%

30
20
10
0
7-10
1Lam

YWF et al. Poster presented at: Annual Meeting of NCDEU; June 10-13, 2002; Boca Raton, Florida.
2Weiden PJ, Zygmunt A. J Prac Psych Behav Hlth. 1997;March:106-110.

()


(%)
48

5
(%)
82

41

74

(n=127)

110

(n=1710)

6,4

11,9

1,98
P=0.0042

1130

16,1

(n=1166)

2,82
P<0.0001

>30

(n=1122)

21,6
<0.004

3,96
P<0.0001

Janssen Pharmaceutica Products, LP. 2003.


100



30 ,

4,2*

80
72,1

60
40

20
20

0
* .
Herings RMC, Erkens JA. The PHARMO Institute, The Netherlands; Submitted to BMJ.

(QALY)
(L. Lenert et al., 2004; P. Mohr et al., 2004)

0,75

0,42

-0,09

-0,05.

-0,05.

-0,14.

-0,22.

-0,22.

- 0,33.

- 0,13


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II

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2393,61
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1427,36

, .

, .

, .

43 512,70

3 660,96
1 168,62
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56 675,49

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(.. , ., 2007)

()

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)

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)

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% , % , % , % , % ,
EMEA

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450

265

1184

4: , , , (>5
) , ?

EMEA 95%

ADHES (2010):

19%


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24%


35%

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22%

...
22

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1 5


:

:

,
, (
- )
()
()
,
( )
,


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(.. , 2006, )

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,


-

2001

14%

2%

2002

2%
0,2%
36%

14%

3% 3%
29%

46%

51%


(.. , 2006, )

/
(80% )

: . , ,
Rating of Medication Influences, ROMI (P. Weiden et al., 1994)
Treatment Compliance Interview, TCI (P. Weiden et al., 1994);
Drug Attitude Inventory (DAI (TP Hogan et al., 1983); Medication Adherence Rating Scale,
MARS (K Thompson et al., 2000).

() (20% ):

, / ).


(..
, .. , 2002)
PANSS (S.R. Key et al., 1987).
(R. Kemp & A. David, 1996).
(G. Szmukler et al., 1994)
(.)

- ASC (S.G. Dott et al.,
2001).

,





()






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- )

()



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Kane JM. Eur Neuropsychopharmacol. 1998;8:55-66.


Kane JM. J Clin Psychiatry. 1983;44(6 Pt 2):3-6.
Vitolins MZ et al. Control Clin Trials. 2000;21(5 Suppl):188S-194S.

National Association of State Mental Health Program Directors. Technical Report on Psychiatric Polypharmacy; 2001.


(.. , 2007).
( -)
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0,8

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0,6
0,5
0,4
0,3
0,2
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0

50

100

150

200

250

300

350

400

,
,
Pekkala E.& Merinder L. Psychoeducation for schizophrenia
(Cochrane Review). // Cochrane Library, Issue 2, Oxford: Update Software, 2003

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