向精神薬服用患者に対する副作用チェックシートの有用性に関する検討

Usefulness of the Side-effect Check Sheet for Patients Taking Psychotropic Drugs

抄録

　向精神薬服用中の患者では副作用の出現が服薬アドヒアランスに大きく影響することが指摘されている。入院患者に対して面接により副作用のモニタリングを行うが，時間的制約，患者の認識不足などから，十分な評価が行えていないと考えられる。そこで自己記述式の全17項目からなる副作用チェックシート(以下，シート)を導入して，副作用の出現状況および苦痛度を調査した。視力障害，下痢，動悸，性欲減退，生理不順の5項目はシートのみで確認された。苦痛度は，胃腸障害，下痢，嘔気，便秘の順に消化器症状が上位を占めた。入院中の患者に対してシートを用いることで，面接のみでは把握できない副作用の確認，より詳細な評価が可能になった。

　The incidence of adverse drug reactions in patients receiving psychotropic drugs significantly affects drug adherence. Generally, side-effect monitoring for hospitalized patients is performed by interview. However, such evaluations are not considered sufficient because of time constraints and lack of patient understanding. In the present study, we introduced a self-descriptive side-effect check sheet consisting of 17 items and investigated the incidence and degree of severity of adverse drug reactions. The participants were 103 patients who provided written consent. Each patient was asked to respond to the survey after approximately 1 week of hospitalization. Their answers were confirmed when the sheet was collected, with the side-effects of vision disturbance, diarrhea, palpitation, decreased libido, and menstrual irregularity confirmed only via the sheet survey. Overall, the incidence of adverse drug reactions confirmed via the sheet survey was 10 times greater than that noted by interview alone. The severity of digestive symptoms, such as gastrointestinal disorders, diarrhea, nausea, and constipation, in descending order of prevalence, were ranked high in the evaluations. Our results suggest that the use of a check sheet for hospitalized patients enabls confirmation of adverse drug effects that are not fully identified by interview and provides a more detailed evaluation.