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1.
Rev. urug. enferm ; 17(1): 1-16, jun. 2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1369117

ABSTRACT

Objetivo: Identificaros fatores relacionados à adesão ao tratamento farmacológico em idosos. Método: trata-se de estudo bibliográfico, tipo revisão integrativa, realizado nas bases de dados LILACS, PubMed, Scopus, Web Of Science e na Biblioteca Virtual SciELO. Consideraram-se os estudos originais, disponíveis na íntegra e publicados no período de 2013 a 2018. Resultado: Localizou-se 1789 publicações, sendo que 352 eram duplicadas, permanecendo 1437. Após leitura dos títulos e resumos encontrou-se 20 artigos para leitura na íntegra e que representou a amostra final. Conclusão: A adesão ao tratamento por idosos sofre a influência de múltiplos fatores, entre eles socioeconômicos e demográficos, relacionados à condição de saúde, sistema e profissionais, relacionados ao tratamento farmacológico e de estilo de vida e comportamento. O suporte de familiares, amigos e grupos sociais de apoio mostrou-se associada à adesão, assim como percepção positiva da visão e audição, ausência de fragilidade e de declínio cognitivo.


Objetivo: Identificar factores relacionados con la adherencia al tratamiento farmacológico en ancianos. Método: se trata de un estudio bibliográfico, tipo de revisión integradora, realizado en las bases de datos LILACS, PubMed, Scopus, Web Of Science y en la Biblioteca Virtual SciELO. Se consideraron los estudios originales, disponibles íntegramente y publicados en el período de 2013 a 2018. Resultado: se encontraron 1789 publicaciones, de las cuales 352 fueron duplicadas, restando 1437. Luego de la lectura de títulos y resúmenes, se encontraron 20 artículos para lectura en el que representó la muestra final. Conclusión: La adherencia al tratamiento por parte de los ancianos está influenciada por múltiples factores, incluidos los socioeconómicos y demográficos, relacionados con la condición, sistema y profesionales de salud, relacionados con el tratamiento farmacológico y el estilo de vida y la conducta. Se demostró que el apoyo de familiares, amigos y grupos de apoyo social está asociado con la adherencia, así como con la percepción positiva de la visión y la audición, la ausencia de fragilidad y el deterioro cognitivo.


Objective: To identify factors related to adherence to pharmacological treatment in the aged. Method: this is a bibliographic study, type of integrative review, carried out in the databases LILACS, PubMed, Scopus, Web Of Science and in the Virtual Library SciELO. The original studies were considered, available in full and published in the period from 2013 to 2018. Result: 1789 publications were found, of which 352 were duplicated, remaining 1437. After reading the titles and abstracts, 20 articles were found for reading in the that represented the final sample. Conclusion: Adherence to treatment by the aged is influenced by multiple factors, including socioeconomic and demographic factors, related to the health condition, system and professionals, related to pharmacological treatment and lifestyle and behavior. The support of family, friends and social support groups was shown to be associated with adherence, as well as positive perception of vision and hearing, absence of fragility and cognitive decline.


Subject(s)
Humans , Socioeconomic Factors , Aged , Family Relations , Medication Adherence , Cognitive Dysfunction
2.
Esc. Anna Nery Rev. Enferm ; 26: e20210282, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1350748

ABSTRACT

Resumo Objetivo avaliar o efeito do monitoramento de enfermagem avançado em relação ao usual para identificação do risco cardiovascular e renal, adesão medicamentosa e prática de exercícios na atenção primária à saúde. Método estudo quantitativo, quase-experimental desenvolvido na Atenção primária. Em relação a intervenção, foram consultas de enfermagem trimestrais de monitoramento avançado e laboratorial trimestral. Para coleta de dados, aplicou-se questionário sociodemográfico, escala Morisky e Questionário Internacional de Atividade Física. Resultados sexo feminino predominou nos dois grupos intervenção e controle (62,79% vs. 76,74%). O percentual de pacientes sem risco cardiovascular do grupo intervenção superou o grupo controle da consulta 1 para consulta 3, (0,00% - 25,58% vs. 6,98 - 2,33). Adesão medicamentosa máxima, ao longo do tempo, foi superior no grupo intervenção comparado ao grupo controle (48,8% vs. 23,3%). O risco cardiovascular dos usuários interferiu na atividade física de forma significativa no grupo intervenção e controle (p=0,0261 vs. 0,0438). Conclusões e implicações para a prática a monitorização avançada possibilitou uma melhor identificação de pacientes de risco e orientações aos pacientes hipertensos e diabéticos com risco cardiovascular e renal, o que favoreceu o monitoramento avançado e contribuiu ao autogerenciamento da prática de exercícios e adesão medicamentosa, a partir de consultas de enfermagem.


Resumen Objetivo evaluar el efecto de la monitorización avanzada de enfermería frente a la habitual para identificar el riesgo cardiovascular y renal, la adherencia a la medicación y la práctica del ejercicio en la atención primaria de salud. Método estudio cuasiexperimental cuantitativo desarrollado en Atención Primaria. En cuanto a la intervención, se realizaron consultas de enfermería trimestrales para seguimiento avanzado y laboratorio trimestral. Para la recopilación de datos se aplicó un cuestionario sociodemográfico, escala de Morisky y Cuestionario Internacional de Actividad Física. Resultados el género femenino predominó tanto en el grupo de intervención como en el de control (62,79% vs 76,74%). El porcentaje de pacientes sin riesgo cardiovascular en el grupo de intervención superó al grupo de control desde la cita 1 hasta la cita 3 (0,00% - 25,58% frente a 6,98 - 2,33). La adherencia máxima al fármaco, a lo largo del tiempo, fue mayor en el grupo de intervención en comparación con el grupo de control (48,8% frente a 23,3%). El riesgo cardiovascular de los usuarios interfirió significativamente con la actividad física en los grupos de intervención y control (p = 0,0261 frente a 0,0438). Conclusiones e implicaciones para la práctica la monitorización avanzada permitió identificar mejor a los pacientes en riesgo y orientar a los pacientes hipertensos y diabéticos con riesgo cardiovascular y renal, lo que favoreció el monitoreo avanzado y contribuyó al autocontrol de la práctica de ejercicio y la adherencia a la medicación, desde las consultas de enfermería.


Abstract Objective to evaluate the effect of advanced versus usual Nursing monitoring to identify cardiovascular and renal risk, adherence to medication and practice of physical exercise in Primary Health Care. Method a quantitative and quasi-experimental study developed in Primary Care. In relation to the intervention, there were quarterly Nursing advanced monitoring consultations and quarterly laboratory control. For data collection, a sociodemographic questionnaire, the Morisky scale and the International Physical Activity Questionnaire were applied. Results the female gender predominated both in the intervention and in the control group (62.79% vs. 76.74%). The percentage of patients without cardiovascular risk in the intervention group exceeded the control group from consultation 1 to consultation 3 (0.00% - 25.58% vs. 6.98 - 2.33). Maximum adherence to medication, over time, was higher in the intervention group when compared to the control group (48.8% vs. 23.3%). The users' cardiovascular risk significantly interfered with physical activity in the intervention and control groups (p=0.0261 vs. 0.0438). Conclusions and implications for the practice advanced monitoring enabled better identification of at-risk patients and guidelines for the hypertensive and diabetic patients at cardiovascular and renal risk, which favored advanced monitoring and contributed to self-management of the practice of physical exercise and adherence to medication, based on Nursing consultations.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Primary Health Care , Exercise , Medication Adherence , Heart Disease Risk Factors , Monitoring, Physiologic/nursing , Control Groups , Office Nursing , Self-Management
3.
Rev. Esc. Enferm. USP ; 56: e20210191, 2022. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1351538

ABSTRACT

ABSTRACT Objective: To characterize the self-reported adherence of patients with cardiovascular diseases to the use of new oral anticoagulants and to identify factors related to adherence to these drugs. Method: This is a descriptive, correlational, and cross-sectional study, carried out with outpatients. The collection of sociodemographic, clinical, and adherence data, through the Measurement of Adherence to Treatments, was made through telephone calls. Descriptive, correlation, and multiple linear regression analyses were used. Results: A total of 120 patients using new anticoagulants for 32.3 months, on average, participated in the study. More than half of the sample consisted of women, who were professionally inactive, with a mean age of 70.1 years and a mean family income of 6.7 minimum wages. The mean adherence score was 5.7, in a possible range between 1 and 6, indicating medication adherence. Inactive employment status, female sex, higher family income, and follow-up at a public outpatient clinic were related to greater adherence to these medications. Conclusion: The patients showed high adherence to new anticoagulants. Employment status, sex, family income, and type of outpatient follow-up were related to medication adherence, and should be considered in the design of interventions for this public.


RESUMEN Objetivo: caracterizar la adhesión autorrelatada de los pacientes con enfermedades cardiovasculares al uso de nuevos anticoagulantes orales e identificar los factores relacionados a la adhesión a esos medicamentos. Método: estudio descriptivo, correlacional y transversal, con paciente ingresado. La recolección de datos sociodemográficos, clínicos y de adhesión, por medio de la Medida de Adhesión a los Tratamientos, ocurrió a través del teléfono. Se utilizaron el análisis descriptivo, correlacional y de regresión lineal múltiple. Resultados: participaron del estudio 120 pacientes que utilizaron nuevos anticoagulantes por 32,3 meses, aproximadamente. Más de la mitad de la muestra estuvo compuesta de mujeres jubiladas, con edad promedia de 70,1 años y remuneración familiar promedia de 6,7 sueldos mínimos. El score promedio de adhesión fue de 5,7, dentro de un período posible entre 1 y 6, lo que indicó adhesión farmacológica. Conclusión: los pacientes presentaron elevada adhesión a los nuevos anticoagulantes. Situación laboral, sexo, renta familiar y tipo de acompañamiento en ambulatorio estuvieron relacionados a la adhesión farmacológica, debiendo ser considerados en la delineación de intervenciones para ese público.


Subject(s)
Nursing , Medication Adherence , Anticoagulants
4.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1354999

ABSTRACT

Objetivo: analisar a classificação da adesão e a organização da assistência de enfermagem em serviços especializados. Método: estudo avaliativo e transversal, com abordagem quantitativa, realizado em cinco Serviços de Assistência Especializada em HIV de Pernambuco, Brasil. Participaram 358 adultos em uso de antirretrovirais e os respectivos enfermeiros dos serviços. Os dados foram coletados por meio de dois instrumentos validados e analisados a partir dos testes estatísticos. Resultados: houve prevalência de uma regular e baixa adesão à terapia antirretrovital. (41,1% e 39,4%, respectivamente). Evidenciou-se que o nível de avaliação da assistência de enfermagem não foi determinante para o escores da adesão. Conclusão: o resultado encontrado no estudo é preocupante, visto a que adesão predominante foi regular. Desenvolver a sistematização da assistência de enfermagem nos serviços especializados deve ser estimulado com vistas à promoção da adesão medicamentosa


Objective: to analyze the classification of adherence and the organization of nursing care in specialized services. Method: evaluative and cross-sectional study, with a quantitative approach, carried out in five Specialized HIV Care Services in Pernambuco, Brazil. Participated 358 adults using antiretrovirals and the respective service nurses. Data were collected using two validated instruments and analyzed using statistical tests. Results: there was a prevalence of regular and low adherence to antiretrovital therapy. (41.1% and 39.4%, respectively). It was evident that the level of assessment of nursing care was not decisive for the adherence scores. Conclusion: the result found in the study is worrying, since the predominant adherence was regular. Developing the systematization of nursing care in specialized services should be encouraged with a view to promoting medication adherence


Objetivo: analizar la clasificación de adherencia y la organización del cuidado de enfermería en servicios especializados. Método: Estudio evaluativo y transversal, con un enfoque cuantitativo, realizado en cinco servicios especializados de atención del VIH en Pernambuco, Brasil. Participaron 358 adultos usando antirretrovirales y las respectivas enfermeras de servicio. Los datos fueron recolectados usando dos instrumentos validados y analizados usando pruebas estadísticas. Resultados: hubo una prevalencia de adherencia regular y baja al tratamiento antirretrovital. (41,1% y 39,4%, respectivamente). Era evidente que el nivel de evaluación de los cuidados de enfermería no fue decisivo para los puntajes de adherencia. Conclusión: el resultado encontrado en el estudio es preocupante, ya que la adherencia predominante fue regular. Se debe fomentar el desarrollo de la sistematización de la atención de enfermería en servicios especializados con el fin de promover la adherencia a la medicación


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , HIV , Antiretroviral Therapy, Highly Active , Medication Adherence , Delivery of Health Care , Anti-Retroviral Agents
5.
Psicol. ciênc. prof ; 42: e235329, 2022.
Article in Portuguese | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1360639

ABSTRACT

Resumo Este artigo apresenta a experiência de pesquisa-intervenção participativa da Gestão Autônoma da Medicação (GAM) com familiares. A GAM, de origem canadense, procura discutir criticamente o uso da medicação psiquiátrica de modo a fomentar a autonomia dos usuários desses medicamentos. No Brasil, o chamado projeto GAM-BR realizou a tradução, adaptação e validação do instrumento utilizado nesta abordagem, o Guia GAM. Seguimos as indicações teórico-práticas da abordagem enativa e empregamos a metodologia da cartografia, em especial a técnica da entrevista cartográfica. Como um projeto participativo, a validação do Guia contou com usuários e trabalhadores dos serviços de saúde mental brasileiros (Caps) como copesquisadores. A realização de um grupo com familiares de usuários na etapa de validação do Guia foi uma inovação na GAM-BR que possibilitou a inclusão desse grupo fundamental para a discussão acerca do tratamento medicamentoso. Podemos destacar dois efeitos processuais desse trabalho com familiares: a promoção de deslocamentos de ponto de vista e a promoção de corresponsabilização. Tais efeitos sugerem perspectivas para a GAM e para o trabalho em saúde mental, em um horizonte de inclusão e composição entre diferentes perspectivas.(AU)


Abstract This article presents the participatory research-intervention experience of Autonomous Medication Management (GAM) with family members. The GAM, a Canadian project, seeks to critically discuss the use of psychiatric medication to foster the autonomy of users of these drugs. In Brazil, the so-called GAM-BR project translated, adapted, and validated the instrument used in this approach, the GAM Guide. We follow the theoretical-practical indications of the enactive approach and employ the cartography methodology, in particular the cartographic interview technique. As a participatory project, the validation of the Guide included users and workers of the Brazilian mental health services (CAPS) as co-researchers. The creation of a group with family members of users in the validation phase was an innovation in GAM-BR that enabled the inclusion of this fundamental group for the discussion about drug treatment. We can highlight two processual effects of this work with family members: the promotion of displacements of points of view and the promotion of co-responsibility. These effects suggest perspectives for GAM and the work in mental health, in a horizon of inclusion and composition between different perspectives.(AU)


Resumen Este artículo presenta la experiencia participativa de intervención-investigación de la Gestión Autónoma de la Medicación (GAM) con miembros de la familia. La GAM es una guía que procede de Canadá y busca discutir críticamente el uso de medicación psiquiátrica para fomentar la autonomía de sus usuarios. En Brasil, el proyecto llamado GAM-BR realizó la traducción, adaptación y validación del instrumento utilizado en este enfoque, la Guía GAM. Se siguieron las indicaciones teóricas y prácticas del enfoque enactivo, y se utilizó la metodología de la cartografía, especialmente la técnica de entrevista cartográfica. Como proyecto participativo, la validación de la Guía incluyó a usuarios y a trabajadores brasileños de los centros de atención a salud mental (CAPS) como coinvestigadores. La creación de un grupo con familiares de usuarios en la etapa de validación de la Guía fue una innovación en GAM-BR por incluir a este grupo de fundamental importancia en la discusión sobre el tratamiento farmacológico. Es posible señalar dos efectos procesales de este trabajo con miembros de la familia: la promoción de los desplazamientos de perspectivas y la promoción de la corresponsabilización. Estos efectos sugieren perspectivas para GAM y el trabajo en salud mental, en un horizonte de inclusión y composición entre diferentes perspectivas.(AU)


Subject(s)
Humans , Male , Female , Research , Family , Mental Health , Medication Adherence , Community-Based Participatory Research , Mediation Analysis , Patient Isolation , Psychology , Pharmaceutical Preparations , Adaptation , Personal Autonomy , Drug Therapy , Psychiatric Rehabilitation , Mental Disorders
7.
Texto & contexto enferm ; 31: e20200552, 2022. tab
Article in English | LILACS, BDENF | ID: biblio-1357484

ABSTRACT

ABSTRACT Objective: to verify the association of adherence and barriers to drug therapy with the risk of falls and the sociodemographic, clinical and economic variables. Method: a cross-sectional study, carried out with 117 aged individuals in a Medical Clinic of Specialties for Older Adults in the Southeast region of the city of São Paulo (SP), from March to November 2019. The following scales were applied: Downton Fall Risk, Morisky-Green Test and Brief Medication Questionnaire. Logistic regression was use to verify the association between adherence to the treatment and types of barriers to adherence and the risk of falls. A 5% significance level was used. Results: the older adults with low adherence to the drug treatment presented 5.57 times more chances of having a high risk of falling when compared to those with greater adherence, and those with a barrier in the recall domain had 22.75 times more chances of having a high risk of falling, in relation to the aged individuals without barriers in the recall domain. Conclusion: low and average adherence to drug therapy and the barrier related to the recall domain were associated with high risk of falls in the older adults.


RESUMEN Objetivo: verificar la asociación de la adhesión y los obstáculos con respecto a la terapia con el riesgo de caídas y las variables sociodemográficas, clínicas y económicas. Método: estudio transversal, realizado con 117 adultos mayores en una Clínica Médica Ambulatoria de Especialidades Geriátricas en la región sudeste de la ciudad de San Pablo (SP) entre marzo y noviembre de 2019. Se aplicaron las siguientes escalas: Riesgo de Caídas de Downton, prueba de Morisky-Green y Brief Medication Questionnaire. Se utilizó regresión logística para verificar la asociación entre la adhesión al tratamiento y los tipos de obstáculos con respecto a dicha adhesión y el riesgo de caídas. Se utilizó un nivel de significancia del 5%. Resultados: los adultos mayores con bajo nivel de adhesión al tratamiento medicamentoso presentaron 5,57 más probabilidades de tener un riesgo de caídas elevado en relación con los que presentaron más adhesión, y quienes tuvieron obstáculos en el dominio Recordatorio presentaron 22,75 más probabilidades de tener un riesgo de caídas elevado, en relación con los adultos mayores sin obstáculos en dicho dominio. Conclusión: los niveles bajo y medio de adhesión a la terapia medicamentosa y el obstáculo relacionado al dominio Recordatorio estuvieron asociados al riesgo de caída elevado en los adultos mayores.


RESUMO Objetivo: verificar a associação da adesão e das barreiras à terapêutica medicamentosa com o risco de quedas e as variáveis sociodemográficas, clínicas e econômicas. Método: estudo transversal, realizado com 117 idosos em um Ambulatório Médico de Especialidades do Idoso na Região Sudeste de cidade de São Paulo (SP), no período de março a novembro de 2019. Foram aplicadas as escalas: Risco de Queda de Downton, teste de Morisky-Green e Brief Medication Questionnaire. Para verificar a associação entre a adesão ao tratamento e tipos de barreiras a essa adesão e o risco de quedas, foi utilizada a regressão logística. Foi utilizado um nível de significância de 5%. Resultados: os idosos com baixa adesão ao tratamento medicamentoso apresentaram chance de 5,57 vezes de ter alto risco de queda em relação aos idosos com maior adesão, e aqueles com barreira no domínio recordação apresentaram chance de 22,75 vezes de ter alto risco de queda, em relação aos idosos sem barreira no domínio recordação. Conclusão: a baixa e média adesão à terapêutica medicamentosa e a barreira relacionada ao domínio recordação se associaram a alto risco de queda nos idosos.


Subject(s)
Humans , Aged , Accidental Falls , Aged , Medication Adherence , Treatment Adherence and Compliance , Barriers to Access of Health Services , Cross-Sectional Studies
8.
Article in English | AIM, AIM | ID: biblio-1362835

ABSTRACT

Background: Since its discovery in late 2019, COVID-19 has claimed approximately three million lives worldwide, causing a significant economic burden and strain on health care delivery and services. Therefore, the COVID-19 vaccine may offer the potential to promote global recovery. Objective: To determine the acceptability of the COVID-19 vaccine among Nigerian doctors and the factors influencing the acceptance. Methods: Using a cross-sectional design, an anonymous online survey was administered to medical doctors across the six geopolitical zones in Nigeria between 13 January and 31 January 2021, using the health belief model (HBM). Results: Out of 830 respondents, 38.8% were willing to take the COVID-19 vaccine, 36.0% were unsure, while the remaining 26.5% refused to take the vaccine. Following adjustments, males were more likely to take the vaccine (OR = 3.357; 95% CI 2.009-5.610; p = 0.0001), whereas increasing age, higher perceived viral virulence and perceived viral infectivity were observed to be significantly associated with less likelihood of accepting the vaccine. Respondents who believed in the efficacy of ivermectin were much less likely to receive the vaccine (OR = 0.217; 95% CI 0.108-0.436; p=0.001). Concerns on vaccination safety were the main barriers to vaccine acceptability. Hypothetically addressing these concerns increased vaccine acceptance rates by approximately a third (34.6%) (p < 0.001). Conclusion: The proposed nationwide distribution of the COVID-19 vaccine may be met with poor vaccine acceptability among Nigerian medical practitioners. Measures specifically addressing vaccine safety concerns should be provided to allay fears and enhance the acceptability of the vaccine.


Subject(s)
Humans , Male , Female , Physicians , Medication Adherence , COVID-19 Vaccines , Mass Vaccination
9.
Afr. J. Clin. Exp. Microbiol ; 23(1): 57-65, 2022.
Article in English | AIM, AIM | ID: biblio-1357605

ABSTRACT

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes. Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p<0.05 was considered as the significant value. Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of 'loss to follow-up' 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p<0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p<0.0001). Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of 'loss to followup' and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.


Subject(s)
Tuberculosis , Patient Compliance , Treatment Outcome , Medication Adherence , Health Facilities
10.
Ciênc. Saúde Colet ; 26(supl.3): 5089-5098, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345723

ABSTRACT

Abstract This article aims to investigate whether difficulty in taking medication is associated with stroke among older adults with Systemic Arterial Hypertension (SAH) and to explore their association with living arrangements. Cross-sectional study was based on 3,502 older adults with SAH from the four universities pole of Frailty in Brazilian Older People (Fibra) Study, Brazil, including 14 municipalities of the five Brazilian regions. We used the medical diagnosis of stroke and difficulty in taking medications (self-reported difficulty and financial difficulty affording prescribed medications). Multivariate analysis was performed using logistic regression. Differently from women, older men with SAH, which report difficulty in taking medication (unintentional non-adherence), have higher odds of stroke. When stratified by living arrangements, those living with a partner have even higher odds of stroke compared to those without difficulty in taking medication and living alone. None association was found for difficulty affording prescribed medication for both men and women. Unintentional difficulty in taking medication plays a role in SAH treatment among men. Primary care strategies for controlling blood pressure should not be focus only on patients but targeting spouses as well.


Resumo O objetivo deste artigo é investigar se a dificuldade em tomar medicamentos está associada ao acidente vascular encefálico (AVE) entre idosos com hipertensão arterial sistêmica (HAS) e explorar esta associação com arranjos familiares. Estudo seccional baseado em 3.502 idosos com HAS dos quatro polos do Estudo Fibra, Brasil, incluindo 14 cidades das cinco regiões brasileiras. Foi usado o diagnóstico médico de AVE e a dificuldade em tomar medicamentos (dificuldade autorrelatada e dificuldade financeira). Utilizou-se a regressão logística na análise multivariada. Diferentemente das mulheres, homens com HAS que relataram dificuldade em tomar medicamentos (não adesão não intencional) apresentam maior chance de ter AVE. Quando estratificado por arranjos familiares, homens que moravam com o cônjuge apresentaram chance ainda maior de ter AVE, quando comparados com aqueles sem dificuldade em tomar medicamentos e que vivem sozinhos. Nenhuma associação foi encontrada para dificuldade financeira, tanto para mulheres quanto para homens. Dificuldades não intencionais em tomar medicamentos têm um papel importante no controle da HAS entre homens. Estratégias de controle da pressão arterial realizadas na atenção primária não devem focar apenas nos pacientes, mas nos cônjuges destes pacientes.


Subject(s)
Humans , Male , Female , Aged , Stroke/epidemiology , Frailty , Hypertension/epidemiology , Blood Pressure , Cross-Sectional Studies , Medication Adherence
11.
Medicina (Ribeirão Preto) ; 54(1)jul, 2021. fig.
Article in English | LILACS | ID: biblio-1353734

ABSTRACT

ABSTRACT: Study Design: This mixed-methods study. Objective: To describe action plans related to the behavior of adher-ence to oral antidiabetic medications produced by people with type 2 diabetes mellitus and identify the challenges and coping strategies for the establishment of this behavior. Methods: The study followed-up 44 people with type 2 diabetes mellitus who used oral antidiabetic medications from southeast Brazil. Adults were invited to build action and coping plans based on the Implementation Intention Theory.The plans were quantitative and qualitatively ana-lyzed. Results: Action plans included three major themes: (1) binding oral antidiabetic medication to time markers or the sleep/wake cycle; (2) in specific environments; (3) associated with daily life activities. The motivation for coping with the perceived barriers focused on placing the pills in visible places, asking for help from family mem-bers, establishing a routine and feeding properly. Conclusions: The most effective way to manage satisfactory oral antidiabetic medication adherence seems to be recognizing the perceived barriers by patients. The implementation of specific and individualized action and coping plans to overcome perceived barriers was the stark difference. (AU)


RESUMO: Desenho do estudo: Estudo de método misto. Objetivo: Descrever planos de ação relacionados ao comportamento de adesão aos antidiabéticos orais elaborados por pessoas com diabetes mellitus tipo 2 e identificar as barreiras percebidas e respectivas estratégias de enfrentamento para efetivação desse comportamento. Métodos: O estudo envolveu 44 pessoas com diabetes mellitus tipo 2 que utilizavam antidiabéticos orais na região sudeste do Brasil. Adultos foram convidados a construir os planos de ação e de enfrentamento de obstáculos baseados sobre a Teoria da Ativação da Intenção. Os planos foram analisados quantitativa e qualitativamente. Resultados: Os planos de ação incluíram três temas principais: (1) Associar a tomada dos antidiabéticos orais aos marcadores de tempo ou ao ciclo de sono / vigília; (2) em ambientes específicos; (3) associados às atividades de vida diária. Os planos de enfrentamento das barreiras percebidas centraram-se em colocar os comprimidos em locais visíveis, pedir ajuda aos familiares para evitar esquecimento, estabelecer rotina e alimentar-se adequadamente. Conclusões: A forma mais eficaz de manejar a tomada de antidiabéticos orais de modo satisfatório parece ser o reconhecimento das barreiras percebidas pela própria pessoa. A implementação de ações específicas e individualizadas bem como de planos de enfrentamento para superar as barreiras percebidas foi o diferencial neste estudo. (AU)


Subject(s)
Humans , Male , Female , Adaptation, Psychological , Planning Techniques , Health Strategies , Diabetes Mellitus, Type 2 , Medication Adherence
12.
Medicina (B.Aires) ; 81(3): 311-317, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346464

ABSTRACT

Resumen La adherencia al tratamiento prescrito en enfermedades crónicas, como ocurre en la esclerosis múltiple (EM), es un factor crítico para una respuesta terapéutica exitosa. El objetivo de este estudio fue evaluar la asociación entre las variables demográficas y la adherencia al tratamiento en una población de pacientes con EM en Argentina. Se realizó un estudio de cohorte retrospectivo de pacientes con EM que recibieron tratamiento con medicamentos modificadores de la enfermedad, incluidos en la base de datos de dispensación de medicamentos del Programa Nacional de Atención Médica: PAMI (Programa Asistencia Médica Integral). La adherencia óptima se definió como una adquisición del fármaco superior al 80% durante un seguimiento de 9 meses. Se incluyó un total de 648 pacientes, edad media 55 años (RIC 46-64), 59.4% mujeres. La adherencia media al tratamiento fue del 67% (RIC 44-89) y la adherencia óptima se documentó solo en el 35.5% de los casos. La adherencia a los medicamentos inyectables fue 10% menor que la de los medicamentos orales (p = 0.0001) y el uso de marcas originales se asoció con una adherencia 7.4% mayor que los medicamentos genéricos (p = 0.001). En conclusión, la adherencia al tratamiento ha sido subóptima. En la región patagónica, el uso de inyectables y de medicamentos genéricos se asoció con una menor adherencia terapéutica. Estos datos son muy importantes para planificar programas socio-sanitarios que tengan como objetivo aumentar la adherencia terapéutica.


Abstract Adherence to prescribed treatment in chronic diseases, as occurs in multiple sclerosis (MS), is a critical factor for a successful therapeutic response. The objective of this study was to evaluate the association between demographic variables and adherence to treatment of the population of MS patients in Argentina. A retrospective cohort study of MS patients who received treatment with disease-modifying drugs, included in the drug dispensing database of the National Care Medical Program: PAMI (Programa Asistencia Médica Integral), was conducted. Optimal adherence was defined as an acquisition of the drug greater than 80% during a 9-month follow-up. A total of 648 patients were included, mean age 55 years (IQR 46-64), 59.4% women. The mean adherence to treatment was 67% (IQR 44-89) and optimal adherence was documented only in 35.5% of cases. Adherence to injectable medications was 10% lower than that of oral drugs (p = 0.0001) and the use of original brands was associated with 7.4% greater adherence than with generic drugs (p = 0.001). In conclusion, adherence to treatment has been suboptimal. In the Patagonian region, the use of injectables and generic drugs was associated with lower adherence to therapy. These data are very important in order to planning socio-sanitary programs that aim to increase therapeutic adherence.


Subject(s)
Humans , Male , Female , Middle Aged , Multiple Sclerosis/drug therapy , Argentina/epidemiology , Retrospective Studies , Medication Adherence
13.
Cambios rev. méd ; 20(1): 74-79, 30 junio 2021.
Article in Spanish | LILACS | ID: biblio-1292925

ABSTRACT

INTRODUCCIÓN. Para el tratamiento farmacoterapéutico de enfermedades respi-ratorias, el uso de herramientas para abordar la vía inhalatoria es de elección por su mayor eficacia y menos efectos secundarios; registrar su adhesión y prevalencia es importante. OBJETIVO. Determinar el nivel y la prevalencia de adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Cróni-ca. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 215 y muestra de 121 Historias Clínicas. Se aplicó el Test de Adhesión a Inhaladores, que consistió en dos cuestionarios complementarios: el de 10 ítems, que valoró el nivel de adhesión, y el de 12 que identificó el tipo de incumplimiento en pacientes de Consulta Externa de la Unidad Técnica de Neumología del Hospital de Especialidades Carlos Andrade Marín, periodo julio 2018 - enero 2019. La tabulación y análisis de datos se realizó con el programa Excel. RESULTADOS. La prevalencia de mala adhesión en asmáticos fue de 83,33% y en Enfermedad Pulmonar Obstructiva Crónica 13,33%. En cuanto al sexo, la prevalencia de mala adhesión fue de 15,28% en hombres y de 40,82% en mujeres, con una p<0,05. No se encontró diferencia significativa respecto a los niveles de instrucción. CONCLUSIÓN. La prevalencia de mala adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Crónica fue alta sobre todo en los asmáticos.


INTRODUCTION. For respiratory diseases and their pharmacotherapeutic treatment, the use of tools to address the inhalation route is chosen due to its greater efficacy and fewer secondary effects; then record the adherence and prevalence is important. OBJECTIVE. To determine both level and prevalence of adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease. MATE-RIALS AND METHODS. Cross-sectional analytical study. Population of 215 and sam-ple of 121 patients. The Inhaler Adherence Test was applied, which consisted of two complementary questionnaires: a 10-item questionnaire, which assessed the level of adherence, and a 12-item questionnaire that identified the type of non-compliance in patients of the Pneumology Technical Unit of the Hospital de Especialidades Carlos Andrade Marín, period July 2018 - January 2019. The tabulation and data analysis was performed with Microsoft Excel program. RESULTS. The prevalence of poor ad-herence in asthmatics was 83.33% and in Chronic Obstructive Pulmonary Disease was 13.3%. Regarding gender, the prevalence of poor adherence was 15.28% in men and 40.82% in women, with a p <0.05. No significant differences were found regarding the levels of instruction. CONCLUSION. The prevalence of poor adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease was high, especially in asthmatics


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Diseases , Asthma , Nebulizers and Vaporizers , Pulmonary Medicine , Pulmonary Disease, Chronic Obstructive , Treatment Adherence and Compliance , Respiratory Therapy , Bronchodilator Agents , Medication Therapy Management , Medication Adherence , Dry Powder Inhalers
14.
Rev. APS ; 23(4): 734-749, 2021-06-23.
Article in Portuguese | LILACS | ID: biblio-1358242

ABSTRACT

O estudo analisa a associação entre letramento funcional em saúde e adesão à medicação anti-hipertensiva. Estudo transversal, com aplicação de formulário a 340 usuários da Estratégia Saúde da Família, segundo características sociodemográficas, relacionadas ao paciente, à doença e ao tratamento, à equipe e ao serviço de saúde. A adesão medicamentosa foi mensurada pela MMAS-8 e o letramento funcional em saúde foi medido pelo B-TOFHLA. Foi utilizado o modelo de regressão de Poisson. A prevalência de não adesão foi de 24,1% (IC95%:19,7­28,5). Baixo letramento funcional em saúde foi encontrado em 80,3% dos hipertensos. Os fatores associados à não adesão foram não acreditar na importância dos medicamentos, maior frequência na tomada dos medicamentos por dia, não compreensão das orientações e explicações dadas pelos profissionais de saúde e maior dificuldade em conversar com os profissionais. Conclui-se que, com mudanças baseadas na complexidade do regime terapêutico, e ainda identificando-se as limitações dos usuários em relação ao acesso e à compreensão das informações e orientações repassadas, a equipe de saúde pode elaborar estratégias que favoreçam a comunicação entre profissionais de saúde e usuários, compensando, assim, os baixos níveis de letramento funcional em saúde.


The study analyzes the association between functional health literacy and adherence to antihypertensive medication. Cross-sectional study, with application of a form to 340 users of the Family Health Strategy, according to sociodemographic characteristics, related to the patient, the disease and treatment, the team and the health service. Medication adherence was measured by MMAS-8 and functional health literacy was measured by B-TOFHLA. The Poisson regression model was used. The prevalence of non-adherence was 24.1% (95%CI: 19.7­28.5). Low functional health literacy was found in 80.3% of hypertensive individuals. Factors associated with non-adherence were not believing in the importance of medications, more frequent taking of medications per day, not understanding the guidelines and explanations given by health professionals, and greater difficulty in talking to professionals. It is concluded that, with changes based on the complexity of the therapeutic regimen, and still identifying the limitations of users in relation to access and understanding of the information and guidelines provided, the health team can develop strategies that favor communication between health professionals. health and users, thus compensating for the low levels of functional health literacy.


Subject(s)
Primary Health Care , Medication Adherence
15.
Rev. bras. oftalmol ; 80(2): 117-126, Mar.-Apr. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1280113

ABSTRACT

RESUMO Objetivo: Comparar por meio de questionários estruturados, o conhecimento sobre a doença, o manejo de colírios e a adesão ao tratamento de portadores de glaucoma pertencentes a dois públicos com nível de escolaridade e nível sócio econômico distintos. Métodos: Foi realizado um estudo transversal analítico aplicando-se questionários estruturados, com base em estudo exploratório para avaliação do nível de conhecimento dos portadores de Glaucoma em relação a doença em dois públicos diferentes: sistema único de saúde (SUS) e planos privados de saúde. Os questionários foram aplicados por médicos residentes em Oftalmologia. A amostra é composta de 202 pacientes dentre eles 100 atendidos pelo SUS e os outros 102 pacientes dos planos privados de saúde. Todos os questionários possuem termo de consentimento livre e esclarecido assinado pelo participante e pelo pesquisador responsável. Resultados: Os pacientes foram divididos em dois grupos, compostos por: 100 pacientes SUS e 102 planos de saúde privado. Os resultados revelaram que: 58,6% dos pacientes do SUS tinham escolaridade nenhuma a fundamental incompleto e 25,5% dos pacientes de convênio tinham algum nível superior); 49% do grupo SUS tinham renda com menos de 2 salários mínimos enquanto que grupo convênio apresentou 39,4% com mais de 4 salários mínimos (p<0,001); 51,5% do grupo SUS não tem gastos com compra de colírios e 67,4% do grupo convênio gasta mais de R$30,00 (p<0,001) portanto 77% do grupo SUS recebe ajuda e 52,5% do grupo convenio não recebe ajuda (p<0,001); 63,6% do grupo convenio acredita que a quantidade de instilações a mais do colírios não obtêm uma melhora do glaucoma, enquanto aproximadamente 50% do grupo SUS relata que há uma melhora com aumento das instilações ou não tem ideia (p=0,030); Ambos os grupos obtiveram um nível de conhecimento geral da doença semelhante, sem diferença estatística. Conclusão: Concluímos que, independente do nível de escolaridade e nível socioeconômico, havendo boa relação médico-paciente, além de acompanhamento orientado e próximo, é possível transmitir conhecimento adequado sobre a doença elevando o nível de adesão ao tratamento pelo paciente.


ABSTRACT Objective: Compare, through structured questionnaires, the knowledge about disease, management of eye drops and adherence to treatment of glaucoma patients disposed in two groups according to educational levels and socioeconomic levels. Methods: A cross-sectional analytical study was carried out applying structured questionnaires based on an exploratory study to assess the level of Glaucoma patients' knowledge relationated with the disease in two different audiences: the single health system (SUS) and private health plans. The questionnaires were used by doctors residents in Ophthalmology. A sample was composed of 202 patients among which 100 were attended by SUS and the others 102 patients were holders of private health plans. All questionnaires have a free and informed consent form signed by the participant and the responsible researcher. Results: Patients were divided into two groups, consisting of: 100 SUS patients and 102 private health plans. The results revealed that: 58.6% of SUS patients had incomplete elementary schooling and 25.5% of private health insurance patients had some level of higher education; 49% of the SUS group had an income with less than 2 minimum wages while the health insurance group presented 39.4% with more than 4 minimum wages (p <0.001); 51.5% of the SUS group has no spending on eye drops and 67.4% of the health insurance group spends more than R $ 30.00 (p <0.001) so, 77% of the SUS group receives financial aid and 52.5% of the health insurance group does not receive any financial support (p <0.001); 63.6% of the health insurance group believes that the bigger amount of instillations than eyedrops does not improve glaucoma, while approximately 50% of the SUS group reports that there is an improvement when increasing instillations or has no idea (p = 0.030); Both groups obtained a similar level of general knowledge of the disease, with no statistical difference. Conclusion: We conclude that regardless of educational and socioeconomic level if prevails a good doctor-patient relationship, in addition to close monitoring, it is possible to transmit adequate knowledge about the disease, increasing levels of treatment adherence.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Glaucoma/psychology , Glaucoma/drug therapy , Ophthalmic Solutions/administration & dosage , Physician-Patient Relations , Socioeconomic Factors , Attitude to Health , Demography , Health Knowledge, Attitudes, Practice , Blindness/prevention & control , Patient Education as Topic , Cross-Sectional Studies , Surveys and Questionnaires , Patient Compliance , Educational Status , Medication Adherence/psychology
16.
Säo Paulo med. j ; 139(2): 99-106, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1290233

ABSTRACT

ABSTRACT BACKGROUND: High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. OBJECTIVES: To identify the sociodemographic profile and level of adherence to ART among women seen at a referral unit in the interior of Pará, northern Brazil. DESIGN AND SETTING: Cross-sectional study at a referral unit for care for PLWHA. METHODS: We included 86 women living with HIV/AIDS (WLWHA) in the Rio Caeté integrated region, northeastern Pará. Social, demographic and behavioral information, as well as the ART level, were obtained using forms that have been described in the scientific literature. Logistic regression models were used to assess associations of variables with ART. RESULTS: Most WLWHA were single (52.4%), young (47.7%) and heterosexual (97.7%), had low levels of education (63.0%), were unemployed (69.8%), had one sexual partner (75.7%), used condoms (46.7%) and were not using either licit drugs (68.7%) or illicit drugs (89.6%). Their adherence level was classified as insufficient , and only their viral load showed an association with ART. CONCLUSIONS: The participants' low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.


Subject(s)
Humans , Female , HIV Infections/drug therapy , HIV Infections/epidemiology , Medication Adherence , Brazil/epidemiology , Cross-Sectional Studies , Viral Load
17.
Medicina (B.Aires) ; 81(1): 11-15, mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1287235

ABSTRACT

Resumen La adherencia al tratamiento médico farmacológico en pacientes que cursaron una hospitalización por un síndrome coronario agudo (SCA) es deficiente. El objetivo primario fue demostrar que, mediante la utilización de una aplicación digital para smartphones, se incrementa por lo menos un 30% la adherencia al tratamiento, en relación al grupo control, en pacientes con SCA. Se realizó un estudio unicéntrico aleatorizado, controlado, con distribución 1:1, simple ciego, que comparó la utilización de una aplicación para smartphones (grupo intervención), frente a la indicación de tratamiento farmacológico por escrito (grupo control), en términos de adherencia médica farmacológica total, en 90 pacientes que cursaron internación por un SCA. La adherencia fue determinada mediante el Cuestionario de Adherencia a la Medicación de Morisky. El paciente se consideró como "totalmente adherente" de obtener un puntaje perfecto (8/8 puntos). El período de seguimiento fue de 90 días posterior al egreso hospitalario. La edad promedio fue 63 ± 9 años, con el 76% de sexo masculino. El objetivo primario ocurrió en 67.4% (31/46) del grupo intervención vs. 20.5% (9/44) del grupo control (p < 0.001). En pacientes que cursaron una hospitalización por SCA, la utilización de una aplicación digital para smartphones incrementó la adherencia al tratamiento médico farmacológico.


Abstract Adherence to cardiovascular medications following acute coronary syndrome hospitalization is generally poor. The primary outcome was to demonstrate that the use of a digital application for smartphones increases the adherence to pharmacological treatment by 30 % in relation to the group without intervention, in patients with an acute coronary syndrome with or without ST segment elevation. In this unicentric, single blinded, randomized controlled trial with 1:1 allocation we compared the use of a digital application for smartphones and written information as standard of care, for the adherence to pharmacological treatment in 90 patients admitted to the hospital with an acute coronary syndrome. Adherence to medical treatment was measured by Morisky Medication Adherence Scale. A patient is considered to have good adherence when score is perfect (8 points). The follow up period was 90 days after hospital discharge. The mean age of the population was 63 ± 9 and 76% were male. At 90 days, 67.4% (31/46) of patients using the smartphone application were adherent compared with 20.5% (9/44) of patients in the control group (p < 0.001). In patients with acute coronary syndrome, the use of a smartphone application increased the medication adherence compared with the standard of care.


Subject(s)
Humans , Male , Female , Acute Coronary Syndrome/drug therapy , Smartphone , Software , Medication Adherence , Secondary Prevention
18.
Rev. colomb. reumatol ; 28(1): 38-45, ene.-mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1341358

ABSTRACT

RESUMEN Introducción: El uso de los fármacos modificadores de la enfermedad (FAME) en pacientes con artritis reumatoide (AR) es esencial para alcanzar y mantener un control adecuado de la enfermedad y prevenir un daño funcional irreversible. Sin embargo, la tasa de adherencia a la terapia farmacológica varía entre el 20% y el 107%. Esta variabilidad puede deberse a los métodos de medición utilizados en los diferentes estudios. Objetivo: Evaluar la adherencia global al tratamiento oral con FAME en pacientes con AR mediante el autodiligenciamiento del cuestionario Compliance Questionnaire on Rheumatology (CQR) y la actividad de la enfermedad e identificar los factores potenciales asociados con la baja adherencia. Métodos: Estudio descriptivo transversal que incluyó pacientes mayores de 18 años con AR clasificados por criterios ACR-EULAR 2010, con prescripción de FAME durante al menos 3 meses y control con reumatólogo en el último año. Los participantes llenaron el cuestionario CQR y se les indagó acerca del conocimiento de la enfermedad, la percepción sobre el tratamiento, los efectos adversos, el índice de comorbilidad de Charlson, el índice global de apoyo social, el número de medicamentos y FAME prescritos, el acceso a los servicios de salud y la actividad de la enfermedad por DAS 28 o CDAI. Se definió como buena adherencia un punto de corte de CQR >80 y ausencia de actividad (remisión o actividad baja). Para la búsqueda de factores asociados con adherencia se analizaron los datos por medio de mediana y rango intercuartílico, así como frecuencias y proporciones. La comparación entre los grupos de adherentes y no adherentes se hizo con comparaciones absolutas, por medio de test de Mann-Whitney para las variables continuas y chi-cuadrado (para valores esperados > 5), o Fisher (para valor esperado < 5) para variables categóricas, tomando como nivel de significancia un valor de p<0,05. Se utilizaron OR y sus respectivos intervalos de confianza al 95% (IC95%). Resultados: De los 170 participantes incluidos, el 50% (n = 85) tuvo un valor de CQR mayor de 80 (buena adherencia). La mayoría de los pacientes se encontraba en remisión (60,6%) o baja actividad de la enfermedad (17%). El análisis posterior únicamente encontró asociación estadísticamente significativa entre adherencia medida por CQR y el número de amigos (p = 0,0012) y entre adherencia medida por actividad de la enfermedad y el índice de soporte social global (p = 0,004). Conclusiones: Este estudio muestra un nivel de adherencia similar al reportado en otras poblaciones, lo cual puede deberse a comportamientos propios de nuestra población, aunque los autores percibieron dificultades reportadas por los pacientes para entender los enunciados del instrumento en todos los niveles de escolaridad. Únicamente las variables de soporte social tuvieron una asociación estadísticamente significativa con la adherencia, asociación descrita en la literatura. Se requieren más estudios para evaluar las características operacionales del CQR en nuestra población.


ABSTRACT Introduction: The use of disease modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA) is essential in order to achieve and maintain adequate disease control, and thus preventing irreversible functional damage. However, the rate of adherence to drug therapy has been reported to be between 20% and 107%. This variability may be due to the measurement methods used in the different studies. Objective: To test the overall medication adherence to oral treatment with DMARD in patients with RA using the self-report Spanish version Compliance Questionnaire on Rheumatology (CQR) and to identify potential factors associated with non-adherence. Methods: A cross-sectional descriptive study was conducted that included patients older than 18 years with RA diagnosed according to the ACR-EULAR 2010 criteria. They also had to have been prescribed oral DMARD for the previous 3 months, and had been seen by a rheumatologist in the last year. Patients completed the CQR to assess adherence, and were asked about disease knowledge, perception about treatment, side effects, Charlson Comorbidity Index, global index of social support, number of medications and DMARD prescribed, access to health resources, and disease activity measured by DAS 28 or CDAI. Good adherence was defined as a cut-off point of CQR > 80 or non-activity (remission or low activity). In the search for factors associated with adherence, the data were analysed using means of median and interquartile range, as well as frequencies and proportions. The comparison between adherent and non-adherent groups was performed using absolute comparisons, with the Mann-Whitney test for continuous, and chi-squared (for expected values > 5), or Fisher (for expected values < 5) tests for categorical variables, taking as a level of significance a value of P < .05. OR and their respective 95% confidence intervals (95% CI) were used. Results: Of 170 participants included, 50% (n = 85) had a value greater than 80% (good drug adherence). Most patients had remission (60.6%) or low disease activity (17%). The subsequent analysis showed statistically significant association between adherence measured by CQR and the number of friends (P = .0012). An association was also found between disease activity as an indirect indicator of adherence and the global social support index (P = .004). Conclusions: This study found a similar level of adherence to that reported in other populations, which could be due to the behaviour of our population, although the authors perceived difficulties reported by patients in understanding the statements of the questionnaire at all levels of education. Only the social support variables had a statistically significant relationship with adherence, which had also been described in the literature. Further studies are required to evaluate the operational characteristics of the CQR in our population.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Arthritis, Rheumatoid , Pharmaceutical Preparations , Colombia , Association , Therapeutics , Comorbidity , Surveys and Questionnaires , Medication Adherence
19.
J. coloproctol. (Rio J., Impr.) ; 41(1): 96-103, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286968

ABSTRACT

Abstract The purpose of this review was to identify interventions that improve adherence to medications in patients with ulcerative colitis (UC). The literature search was carried out between April and June 2020 in the PubMed/MEDLINE database, with the combination of MeSH terms medication adherence; intervention; ulcerative colitis; and inflammatory bowel disease.We restricted our search to articles published in English and Portuguese between March 2010 and March 2020. After the selection, recovery of fulltext articles and analysis of the defined criteria, the interventions described in the studies were classified into four domains: educational; behavioral, cognitive behavioral, and multicomponent. In total, six clinical trials met the inclusion criteria and were analyzed. Half of the studies (3; 50%) used multicomponent interventions, 2 (33.3%) focused on behavioral interventions, and 1 (16.7%) applied isolated educational interventions. All studies used indirect methods to measure adherence, with an emphasis on scales and questionnaires. Half of the studies (3; 50%) showed a positive impact on adherence in patients with UC, with evidence that multicomponent interventions, when properly implemented in a clinical trial combining direct and indirect methods to measure medication adherence, appear to increase the chances of better results. We believe that future studies focusing on improving adherence in patients with UC are necessary.


Resumo O objetivo desta revisão foi identificar intervenções para a melhoria da adesão a medicamentos em pacientes com colite ulcerativa (CU). A busca na literatura foi realizada entre abril e junho de 2020 na base de dados do PubMed/MEDLINE, com a combinação dos descritores medication adherence; intervention; ulcerative colitis; e inflammatory bowel disease. Restringimos a busca aos artigos publicados em inglês e português entre março de 2010 e março de 2020. Após a seleção, recuperação dos textos dos artigos, e análise dos critérios definidos, as intervenções descritas nos estudos foram classificadas em quatro domínios: educacional; comportamental, cognitivo comportamental, e multicomponente. No total, seis ensaios clínicos atenderam aos critérios de inclusão e foram analisados. Metade dos estudos (3; 50%) usaram intervenções do tipo multicomponente, 2 (33.3%) centraram-se em intervenções comportamentais, e 1 (16.7%) aplicou intervenções educacionais isoladamente. Todos os estudos utilizaram métodos indiretos para mensurar a adesão, comênfase em escalas e questionários. Metade dos estudos (3; 50%) demonstraram impacto positivo na adesão em pacientes com CU, com indícios de que intervenções do tipo multicomponente, quando apropriadamente implementadas em ensaio clínicos que associam métodos diretos e indiretos para a mensuração da adesão a medicamentos, parecem aumentar as chances de melhores resultados. Consideramos que estudos futuros centrados na melhoria da adesão em pacientes com CU se fazem necessários.


Subject(s)
Humans , Male , Female , Colitis, Ulcerative/drug therapy , Medication Adherence/statistics & numerical data , Self-Management/statistics & numerical data
20.
Nursing (Säo Paulo) ; 24(274): 5419-5432, mar.2021. tab
Article in Portuguese | SES-SP, LILACS, BDENF, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1223456

ABSTRACT

OBJETIVO: Avaliar a adesão do paciente com Fibrilação Atrial em Terapia com anticoagulante oral cumarínico. MÉTODO: Estudo descritivo-exploratório, transversal e prospectivo com intervenção não randomizado de abordagem quantitativa, realizado com 40 participantes, aplicou-se o Escore de Adesão Simonetti e a Escala de Avaliação Analógica Visual e após a intervenção educativa para análise de Time in Therapeutic Range sob CAAE: 79973017.1.0000.5462. RESULTADO: Identificou-se que 5% apresentaram risco baixo de adesão, 60% risco médio e 35% risco alto. Após análise dos oito meses do TTR pré e pós-intervenção, não houve mudança significativa entre os períodos (p=0,638). CONCLUSÃO: Evidenciou-se que o grupo de baixa adesão manteve melhor tempo na faixa terapêutica relacionado ao médio e alto risco. Indicativo este de maior impacto da intervenção educativa realizada pelo enfermeiro.


OBJECTIVE: to evaluate the adherence of the patient with Atrial Fibrillation in Therapy with oral coumarin anticoagulant. METHOD: Descriptive-exploratory, cross-sectional and prospective study with a non-randomized intervention with a quantitative approach, carried out with 40 participants, the Simonetti Adherence Score and the Visual Analog Evaluation Scale were applied and after the educational intervention for analysis of Time in Therapeutic Range under CAAE: 79973017.1.0000.5462. RESULT: It was identified that 5% had low risk of adherence, 60% medium risk and 35% high risk. After analyzing the eight months of TTR before and after intervention, there was no significant change between the periods (p = 0.638). CONCLUSION: It was evidenced that the low adherence group maintained a better time in the therapeutic range related to medium and high risk. Indicative of greater impact of the educational intervention carried out by the nurse.


OBJETIVO: evaluar la adherencia del paciente con fibrilación auricular en terapia con anticoagulante cumarínico oral. MÉTODO: Estudio descriptivo-exploratorio, transversal y prospectivo con una intervención no aleatorizada con abordaje cuantitativo, realizado con 40 participantes, se les aplicó el Simonetti Adherence Score y la Escala de Evaluación Visual Analógica y luego de la intervención educativa para el análisis del Tiempo en el Rango Terapéutico bajo CAAE: 79973017.1.0000.5462. RESULTADO: Se identificó que 5% riesgo bajo de adherencia, 60% riesgo medio y 35% riesgo alto. Después de analizar los ocho meses de TTR antes y después de la intervención, no hubo cambios entre los períodos (p = 0,638). CONCLUSIÓN: Se evidenció que el grupo de baja adherencia mantuvo el mejor tiempo en el rango terapéutico relacionado con riesgo medio y alto. Indicativo de mayor impacto de la intervención educativa realizada por la enfermera.


Subject(s)
Humans , Atrial Fibrillation , Medication Adherence , Anticoagulants , Therapeutics , Patient Compliance
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