Background 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. Methods 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. Correlations between the IFS and total scores and scores on the five 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). Results We found significant negative correlation between the IFS and the PANSS total score in whole patients with schizophrenia (beta=-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 in patients with TRS (rho=-0.37, p=0.011), 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 in patients with TRS, respectively (p<0.05). 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<0.05). Conclusions 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.

中文翻译：

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临床医生遵守药物治疗指南建议与精神分裂症患者精神病症状之间的关系

背景 临床医生在精神分裂症药物治疗中遵守指南建议对于患者获得良好的治疗效果非常重要。为了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：个体健康评分（IFS）。目前尚不清楚遵守指南是否与患者的治疗结果有关。在这里，我们研究了精神分裂症患者的 IFS 值与精神病症状之间的相关性。方法 我们使用 IFS 分别对 47 名难治性精神分裂症 (TRS) 患者和 353 名非 TRS 患者（总计 n=400）评估了患者当前处方是否遵守指南建议。IFS 与总分以及阳性和阴性症状量表 (PANSS) 五个分量表分数之间的相关性。此外，我们还探讨了一些患者 (n=77) 超过 2 年的 IFS 值纵向变化与精神病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's rho=-0.15，p=4.40×10 -3）和 TRS 患者（rho=-0.37，p=0.011）中，IFS 与 PANSS 总分显着负相关。分别。在非TRS患者和TRS患者中，IFS还分别与多种因素显着且名义上负相关，例如消极因素和抑郁因素（p＜0.05）。此外，IFS值的变化与PANSS总分以及积极因素和消极因素得分的变化呈轻微负相关(p＜0.05)。结论 这些研究结果表明，根据 IFS 的评估，努力提高临床医生对精神分裂症药物治疗指南建议的依从性，可能会给精神分裂症患者带来更好的结果。