MANIFESTATIONS AND ATTITUDES ABOUT DIFFICULTIES IN ADHERENCE TO PHARMACOLOGICAL TREATMENT IN THE UNIVERSE OF PRIMARY CARE
ADHERENCE TO PHARMACOLOGICAL TREATMENT IN THE UNIVERSE OF PRIMARY CARE
DOI:
https://doi.org/10.13037/ras.vol23.e20259641Keywords:
medication adherence, primary health care, aged, hypertension, public health, chronic diseaseAbstract
Introduction: Systemic Arterial Hypertension is a pathology with high prevalence and impact on the lives of the elderly population, emphasizing the need for constant and adequate treatment, whose impact is crucially influenced by multifactorial agents such as pharmacological adherence and rational use of medicines. Objectives: This study aims to understand pharmacotherapeutic non-adherence among elderly people with hypertension treated at a Primary Healthcare Unit. Materials and Methods: It is a qualitative study involving description and content analysis, conducted with 20 elderly hypertensive patients who had difficulties adhering to the proposed therapeutic plan and were registered at a Primary Healthcare Unit in the South Zone of São Paulo. Data collection took place through in-depth interviews based on a questionnaire with pre-formulated questions, from January to February 2024. Laurence Bardin's methodology was used for subsequent content analysis. Results: Medication adherence among hypertensive elderly people was affected by several factors, such as memory lapses, a superficial perception of the pathology combined with a sense of autonomy, alcoholism, side effects of pharmacotherapy, polypharmacy, limited understanding of the benefits of treatment, and low availability of medicines. Conclusion: pharmacotherapeutic adherence is multifactorial, which highlights the relevance of care that adopts the patient's perspective as a biopsychosocial being, taking into account their individuality and particular demands, thus allowing the identification of the feelings underlying the diagnosis and treatment.
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References
Duarte Elisabeth Carmen, Barreto Sandhi Maria. Transição demográfica e epidemiológica: a Epidemiologia e Serviços de Saúde revisita e atualiza o tema. Epidemiol. Serv. Saúde [Internet]. 2012 Dez [citado 2024 Maio 12] ; 21( 4 ): 529-532. Disponível em: http://scielo.iec.gov.br/scielo.php?script=sci_arttext&pid=S1679-49742012000400001&lng=pt. http://dx.doi.org/10.5123/S1679-49742012000400001.
Manso MEG, Biffi ECA, Gerardi TJ. Prescrição inadequada de medicamentos a idosos portadores de doenças crônicas em um plano de saúde no município de São Paulo, Brasil. Rev bras geriatr gerontol [Internet]. 2015Jan;18(1):151-64. Available from: https://doi.org/10.1590/1809-9823.2015.14056
Ministério da Saúde (BR). Secretaria de Atenção à Saúde. Departamento de Atenção primária. Hipertensão arterial sistêmica para o Sistema Único de Saúde. Brasília (DF): Ministério da Saúde; 2006a. 58 p. (Cadernos de Atenção primária; 15. Série A. Normas e Manuais Técnicos).
World Health Organization. Global Health Estimates. Geneva: World Health Organization; 2019
de Oliveira Lopes T, de Castro Santos J, Ribeiro Bitencourt G, Mônica Andrade A, Alves Silva R, Lopes ROP. Interdependence in the therapeutic compliance of hypertensive older adults during the COVID-19 pandemic. Rev esc enferm USP [Internet]. 2022;56:e20210537. Available from: https://doi.org/10.1590/1980-220X-REEUSP-2021-0537
Doyle AE. Hypertension and vascular disease. American Journal of Hypertension [Internet]. 1991 Feb 1;4(2 Pt 2):103S106S. Available from: https://pubmed.ncbi.nlm.nih.gov/2021454/
Tavares NUL, Bertoldi AD, Thumé E, Facchini LA, França GVA de, Mengue SS. Fatores associados à baixa adesão ao tratamento medicamentoso em idosos. Rev Saúde Pública [Internet]. 2013Dec;47(6):1092-101. Available from: https://doi.org/10.1590/S0034-8910.2013047004834
Luz AL de A, Silva-Costa A, Griep RH. Pressão arterial não controlada entre pessoas idosas hipertensas assistidas pela Estratégia Saúde da Família . Rev bras geriatr gerontol [Internet]. 2020;23(4):e200211. Available from: https://doi.org/10.1590/1981-22562020023.200211
Ministério da Saúde. Portaria nº 3.916, de 30 de outubro de 1998. Aprova a Política Nacional de Medicamentos. Diário Oficial da União, seção 1, p. 215. Brasília, DF, 30 out. 1998.
Ministério da Saúde. Portaria de Consolidação nº 2, de 28 de setembro de 2017. Consolidação das normas sobre as políticas nacionais de saúde do Sistema Único de Saúde. Diário Oficial da União [Internet], Brasília (DF). 28 set. 2017. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prc0002_03_10_2017.html
Marin NS, Santos MF dos, Moro A dos S. Perception of hypertensive patients about their non-adherence to the use of medication. Rev esc enferm USP [Internet]. 2016Jun;50(spe):61-7. Available from: https://doi.org/10.1590/S0080-623420160000300009
Pereira NPA, Lanza FM, Viegas SM da F. Living under treatment for Systemic Hypertension and Diabetes Mellitus: Feelings and behaviors. Rev Bras Enferm [Internet]. 2019Jan;72(1):102-10. Available from: https://doi.org/10.1590/0034-7167-2016-0500
Ministério da Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União [Internet], Brasília (DF). 13 jul. 2013. Seção 1:59. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html
Dos Santos GT, Filho VH de O, Royer R, Porto Rosa AF. Método para aplicar entrevistas em profundidade: avaliando causas de baixo desempenho em um operador logístico. Revista Gestão Industrial. 2016 Dec 1;12(4).
Haynes RB, Taylor DW, Sackett ED. Compliance in Health Care. Baltimore: The Johns Hopkins University Press; 1979.
Oliveira GL, Lula-Barros DS, Silva DLM, Leite SN. Fatores relacionados à adesão ao tratamento sob a perspectiva da pessoa idosa. Rev bras geriatr gerontol [Internet]. 2020;23(4):e200160. Available from: https://doi.org/10.1590/1981-22562020023.200160
Queiroz MIP de. Variações sobre a técnica de gravador no registro da informação viva. 1991; [citado 2023 abril 24]
BARDIN, Laurence. Análise de conteúdo Lisboa: Edições 70, 1977.
Lopes RGC. As interpretações sociais e os reflexos no uso do medicamento. Tese [Doutorado em Saúde Pública] - Faculdade de Saúde Pública da USP; 1999.
Abegaz TM, Shehab A, Gebreyohannes EA, Bhagavathula AS, Elnour AA. Nonadherence to antihypertensive drugs. Medicine [Internet]. 2017 Jan;96(4):e5641. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287944/
Aiolfi CR, Alvarenga MRM, Moura C de S, Renovato RD. Adesão ao uso de medicamentos entre idosos hipertensos. Rev bras geriatr gerontol [Internet]. 2015Apr;18(2):397-404. Available from: https://doi.org/10.1590/1809-9823.2015.14035
Salas M, Bas, Paul, Hofman A, Monique M.B. Breteler, Ch BH. Impaired cognitive function and compliance with antihypertensive drugs in elderly: The Rotterdam Study. Clinical Pharmacology & Therapeutics. 2001 Dec 1;70(6):561-6.
Rodrigues E, Rolim A, Almeida C. Percepção dos clientes hipertensos acerca das complicações da hipertensão arterial sistêmica. Revista Interfaces: Saúde, Humanas e Tecnologia. 2014 Nov 19;2(5).
Rios MC, Prata MS, Rios PS de S, Balisa-Rocha BJ, Brito GC, Junior DP de L. Percepções de idosas quanto a não adesão a farmacoterapia: uma análise qualitativa. Revista de Ciências Farmacêuticas Básica e Aplicada [Internet]. 2015 Jul 1;36(3).
Kanikadan PYS. O grande benefício para a humanidade. Hist cienc saude-Manguinhos [Internet]. 2010Apr;17(2):548-50. Available from: https://doi.org/10.1590/S0104-59702010000200020
Santos ECB, Zanetti ML, Otero LM, Santos MA. O cuidado sob a ótica do paciente diabético e de seu principal cuidador. Rev Latino-Am. Enf. 2005;13(3):397-406.
Magnabosco P, Teraoka EC, Oliveira EM de, Felipe EA, Freitas D, Marchi-Alves LM. Comparative analysis of non-adherence to medication treatment for systemic arterial hypertension in urban and rural populations. Rev Latino-Am Enfermagem [Internet]. 2015Jan;23(1):20-7. Available from: https://doi.org/10.1590/0104-1169.0144.2520
Sousa RC, Lucena ALR, Nascimento WS, Ferreira TMC, Lima CLJ, Ferreira JDL, Matos SDO, Costa MML. Particularidades de idosos hipertensos à adesão ao tratamento medicamentoso. Rev enferm UFPE on line [Internet]. 2018 [cited 2024 Apr 22];216-23.
Alves VS. Um modelo de educação em saúde para o Programa Saúde da Família: pela integralidade da atenção e reorientação do modelo assistencial. Interface (Botucatu) [Internet]. 2005Feb;9(16):39-52. Available from: https://doi.org/10.1590/S1414-32832005000100004
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