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Motiverende gespreksvoering bij patiënten met schizofrenie ...Samenvatting
Therapieontrouw aan antipsychotische medicatie is een frequent voorkomend probleem bij patiënten met schizofrenie of een aanverwante stoornis. Het zorgt bij hen voor een drie tot vijf maal grotere kans op terugval, opname en suïcide. Er bestaat een aantal interventies die trachten de therapietrouw bij deze doelgroep te verhogen, maar geen daarvan is eenduidig effectief gebleken. Motiverende gespreksvoering blijkt effectief te zijn om verslaafde patiënten tot verandering te bewegen. Hoewel de wetenschappelijke evidentie op dit gebied nog niet eenduidig is, lijkt de methodiek ook nuttig om patiënten met schizofrenie te verleiden tot betere therapietrouw. Er lopen op dit moment verschillende onderzoeken om dat uit te wijzen. In dit artikel wordt een kort overzicht gegeven van motiverende gespreksvoering, de aanpassingen waaraan kan worden gedacht bij patiënten met psychotische stoornissen, en aan de hand van twee casussen wordt gedemonstreerd hoe de techniek kan worden toegepast om bij deze doelgroep een betere therapietrouw te bereiken.
Summary
Non-adherence to antipsychotic medication in patients with schizophrenia and related psychotic disorders is a frequently observed problem. Within this group of patients, non-adherence is associated with three to five times higher rates in relapse, admission and suicide. Several therapeutic interventions have been tried to improve medication adherence, but so far none has shown a robust effect. Motivational interviewing has proven its effectiveness in changing addictive behaviour. This method also appears to be useful to improve medication adherence in schizophrenic patients. So far however, research has not yet provided unambiguous support for this, and more research in this topic is conducted at present. This article presents an overview on motivational interviewing, adaptations that may be useful for patients with psychotic disorders, and concludes with two case examples on how motivational interviewing can be used to increase medication compliance within this group of patients.
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