Incumplimiento farmacológico en pacientes con epilepsia / Non-compliance with pharmacological treatment in patients with epilepsy

RESUMEN

Introducción. Los factores que influyen en la adherenciaal tratamiento farmacológico anticonvulsionante son múltiples ypueden clasificarse en psicosociales, educativos y relacionadoscon la medicación y la relación médico-paciente. El incumplimientofarmacológico genera falta de control de crisis, recurrencia,incremento del absentismo laboral y, eventualmente, lesiones a unomismo o a terceros. Objetivo. Determinar las variables asociadasal cumplimiento farmacológico en un sector de la población dePerú y su respectivo análisis. Pacientes y métodos. Se incluyeron114 pacientes evaluados entre junio de 2001 y diciembre de 2002en el Departamento de Epilepsia y Electroencefalografía Clínicadel Instituto Especializado de Ciencias Neurológicas Óscar TrellesMontes. Resultados. En este estudio, el grado de incumplimientofarmacológico fue del 67,2% y los incumplidores del tratamientoanticonvulsionante presentaron un menor control de sus crisis. Lasvariables que se asociaron significativamente con el incumplimientodel tratamiento farmacológico fueron falta de dinero para lamedicación, no aceptación de la enfermedad, pobre respuesta altratamiento, creencia que el tratamiento no ayuda o no es beneficiosoy factores asociados a la relación médico-paciente. Los pacientesincumplidores consideraron que el no poder cubrir el costede la medicación era la principal causa por la que habían dejadode tomar el tratamiento

ABSTRACT

Introduction. The factors that affect adherence to pharmacological treatment with anticonvulsive drugs are manifoldand can be classified as psychosocial, educational and related to the medication and the relation between physician andpatient. Non-compliance with pharmacological treatment leads to lack of control over seizures, recurrence, increasedabsenteeism from work and, possibly, injury to oneself or to others. Aims. To determine and to analyse the variablesassociated to compliance with pharmacological treatment in a sector of the population in Peru. Patients and methods. Thesample consisted of 114 patients evaluated between June 2001 and December 2002 at the Epilepsy and Clinical ElectroencephalographyDepartment of the National Neurological Sciences Institute Óscar Trelles Montes in Lima. Results. In thisstudy the rate of non-compliance with the pharmacological regimen was 67.2% and those who did not adhere to the anticonvulsivetherapy had poorer control over their seizures. The variables that were significantly associated to non-compliancewith the pharmacological treatment were lack of money to buy the medicine, patient’s failure to acknowledge the disease,poor response to treatment, belief that the treatment is of no use or has no beneficial effects, and factors linked to therelationship between physician and patient. Patients who did not comply claimed that not being able to afford the medicationwas the most frequent reason why they had stopped following the treatment