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Étude sur la perception du traitement injectable dans le muscle deltoïde par les patients souffrant de troubles schizophréniques - 01/03/12

Doi : 10.1016/j.encep.2011.12.013 
B. Millet a, , R. Gourevitch b, D. Levoyer c, G. Parmentier d, C. Joly e
a CHU Pontchaillou, CHS Guillaume-Régnier, université Rennes 1, 108, avenue du Général-Leclerc, 35000 Rennes, France 
b CH Sainte-Anne, service universitaire de santé mentale et de thérapeutique, 7, rue Cabanis, 75674 Paris, France 
c CHS Guillaume Régnier, 35000 Rennes, France 
d 1, boulevard Carnot, 81000 Albi, France 
e Centre de jour Janet, 86, rue Rémy-Duquesnoy, 59220 Denain, France 

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Résumé

Malgré des avantages reconnus aux antipsychotiques par voie injectable, il existe encore des réticences face à ces traitements, tant de la part de certains patients que de la part des professionnels de santé. Une enquête réalisée en 2007 auprès de patients souffrant de trouble schizophrénique avait montré que près de la moitié de ces patients préférait une forme injectable et se sentaient ainsi mieux accompagnés. Il existe aujourd’hui la possibilité de choisir entre deux sites d’injection : le muscle deltoïde ou le muscle glutéal. L’enquête présentée ici (réalisée par l’Institut de sondage BVA en 2011) vise à recueillir le point de vue des patients sur ce nouveau choix et les changements qu’il induit. Deux cent quatre-vingts un patients avec une maladie schizophrénique suivis en ambulatoire et sous traitement injectable à action prolongée ont été interrogés. Il ressort de cette enquête que 75 % des patients disent se sentir mieux suite à la prise d’un traitement injectable. Le choix du site d’injection, montrant une préférence pour le muscle deltoïde, est important pour une majorité (70 %), renforçant leur sentiment d’être acteur de leur traitement. Ils se sentent ainsi plus impliqués dans le suivi de celui-ci, ce qui devrait favoriser une meilleure observance.

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Summary

Despite the advantages of antipsychotic treatments via the injectable route of administration, there are still reservations regarding this type of therapy, notably among health professionals. A survey conducted with patients suffering from schizophrenic disorders revealed the positive opinion that they had of their treatment. Another survey showed that nearly half of the patients preferred an injectable form, and two thirds felt they were cared for better, because of the injectable treatment. The slow release form of risperidone allows a choice between two injection sites: the deltoid muscle or the gluteal muscle. A recent study showed the satisfaction of the health professionals towards this novel form. The survey presented here was aimed at collecting the opinion of patients regarding the possibility of choosing the injection site, and the changes it would make.

Objectives and methods

The survey was carried out by the BVA Institute during the first half of 2011. The interviews with the schizophrenic patients, followed-up as out patients and treated with long lasting antipsychotics (n=281), were conducted face to face at the hospital by BVA interviewers specialised in the field of health, without the presence of any health professionals. A total of 32 centres participated in the survey; 38% of the interviews took place in the Paris area and 62% in various regions.

Results

Different dimensions were analysed. (1) The perception of injectable treatment was largely positive: among all the patients, 75% claimed they currently felt better once they had started the injectable treatment. (2) The choice of the injection site appeared important to a majority of patients (70% of the total sample; 79% of patients had experienced both sites of injection), 56% claimed that it was legitimate that they be given the choice and they felt that they were thus able to participate in their treatment (58%), their treatment was more acceptable (54%), and they found that their relationship with the doctor or nurse was enhanced (53%). (3) The preference regarding the injection site went to the deltoid muscle, among those who had experienced both sites. (4) The perception of the injection sites confirms this preference, the positive qualifications often being associated with the deltoid site, and the negative qualifications with the gluteal site.

Conclusion

The survey presented here could contribute in convincing the health professionals to propose the choice to patients between the two injection sites in order to improve their compliance to treatment. Patients would therefore play a role in the choice of their treatment and hence become more involved in the follow-up.

Il testo completo di questo articolo è disponibile in PDF.

Mots clés : Schizophrénie, Antipsychotique injectable, Choix, Deltoïde, Observance

Keywords : Schizophrenia, Injectable treatment, Antipsychotics, Adherence


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© 2012  Pubblicato da Elsevier Masson SAS.
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