目的：旨在评估基于社区健康管理模式下精神分裂症患者接受长效可注射抗精神病药物（long-acting injectable antipsychotics，LAIA）治疗的疗效及依从性，并分析影响其依从性的相关因素，为优化社区LAIA治疗方案提供科学依据。

方法：选取2021年7月1日～2022年6月30日于上海市长宁区精神卫生中心就诊且经精神科医生评估适用LAIA治疗的精神分裂症患者作为研究对象。分别于治疗开始时和治疗1年后，对所有入组患者进行临床特征调查，并采用以下量表进行疗效评估：家庭负担量表（Family Burden Scale，FBS）、世界卫生组织生存质量测定量表简表（World Health Organization Quality of Life-Brief Scale，WHOQOL-BREF）、社会功能缺陷筛选量表（Social Disability Screening Schedule，SDSS）、简明精神病评定量表（Brief Psychiatric Rating Scale，BPRS）及精神病症状维度评定量表（Clinician-Rated Dimensions of Psychosis Symptom Severity，CRDPSS）。采用配对秩和检验比较治疗前后各量表评分的差异，采用成组秩和检验比较不同依从性精神分裂症患者之间各量表评分的差异。采用χ²检验分析不同依从性精神分裂症患者之间基线临床特征的差异，并且采用多因素logistic回归分析探讨影响精神分裂症患者LAIA治疗依从性的相关因素。

结果：本研究共纳入116例精神分裂症患者，其中79例（68.1%）患者依从性好，37例（31.9%）患者依从性差。依从性好组与依从性差组患者的职业状况、医药费用来源、家庭监护情况、社会参与情况以及既往住院次数等的差异均有统计学意义（P均＜0.05）。精神分裂症患者接受LAIA治疗1年后的FBS、WHOQOL-BREF、BPRS以及CRDPSS评分均与治疗前存在显著差异（P均＜0.05）。医药费用来源、既往住院次数和社会参与情况是影响精神分裂症患者LAIA治疗依从性的独立预后因素（P均＜0.05）。

结论：在社区健康管理模式下，LAIA可以有效改善精神分裂症患者的精神病症状、提升生活质量以及减轻家庭负担，同时还能够提高其治疗依从性，但是部分患者仍存在治疗依从性不佳的问题。在未来的社区健康管理实践中，可以通过加强照顾者履行监护责任、鼓励患者积极参与社会活动以及降低患者疾病复发再住院率等措施以优化社区LAIA治疗方案，进一步提高社区精神分裂症患者的LAIA治疗依从性和整体疗效，从而促进其更好地回归社会。

Objective: To evaluate the efficacy and compliance of long-acting injectable antipsychotics (LAIA) in schizophrenia patients under the community-based health management model, and to analyze the compliance influencing factors, so as to provide a scientific basis for optimizing the application of LAIA in community.

Methods: Schizophrenia patients who were evaluated by psychiatrists as suitable for LAIA treatment in Shanghai Changning District Mental Health Center from July 1, 2021 to June 30, 2022 were selected as the subjects. At the start of treatment and after 1 year of treatment, all enrolled schizophrenia patients underwent personal clinical characteristic assessments using Family Burden Scale (FBS), World Health Organization Quality of Life-Brief Scale (WHOQOL-BREF), Social Disability Screening Schedule (SDSS), Brief Psychiatric Rating Scale (BPRS) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS). The differences in the scores of the scales before and after LAIA treatment were analyzed by paired-samples rank-sum test, the differences in the scores of the scales among schizophrenia patients with different compliance were analyzed by the independent-samples rank-sum test. The χ² test was used to analyze the differences in baseline clinical characteristics among schizophrenia patients with different compliance, and multivariable logistic regression was used to analyze the factors influencing the compliance of schizophrenia patients receiving LAIA treatment.

Results: This study included a total of 116 patients with schizophrenia, of whom 79 (68.1%) had good compliance and 37 (31.9%) had poor compliance. There were statistically significant differences in occupational status, source of medical expenses, family supervision, social participation, and previous hospitalization frequency between the good compliance group and the poor compliance group (all P<0.05). After one year of LAIA treatment, the scores of FBS, WHOQOL-BREF, BPRS, and CRDPSS for schizophrenia patients showed significant differences compared to those before treatment (all P<0.05). Source of medical expenses, previous hospitalization frequency, and social participation were independent factors affecting the compliance of schizophrenia patients receiving LAIA treatment (all P<0.05).

Conclusion: Under the community health management model, LAIA can effectively improve the psychiatric symptoms of schizophrenia patients, enhance their quality of life, and reduce their family burden, and while enhance their compliance, but some patients still face issues with poor compliance. In future community health management practices, measures such as strengthening the responsibility of caregivers, encouraging patients to actively participate in social activities, and reducing the rate of disease recurrence and re-hospitalization can be taken to optimize the LAIA treatment in community. This will further improve the compliance and overall efficacy of LAIA treatment for schizophrenia patients in community, thereby facilitating their better integration into society.