Adriano Liana Silveira, de França Fonteles Marta Maria, de Fátima Menezes Azevedo Maria, Beserra Milena Pontes Portela, Romero Nirla Rodrigues
Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil; Hospital Infantil Albert Sabin (HIAS), Fortaleza, CE, Brazil.
Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
Rev Bras Reumatol Engl Ed. 2017 Jan-Feb;57(1):23-29. doi: 10.1016/j.rbre.2016.05.004. Epub 2016 May 30.
The aim of this study was to investigate pharmacological treatment adherence of patients with juvenile idiopathic arthritis, attended in an outpatient pharmacy at a tertiary hospital in northeastern Brazil.
The analysis of adherence was performed along with caregivers, through a structured questionnaire based on Morisky, Green and Levine, which enabled the categorization of adherence in "highest", "moderate" or "low" grades, and through evaluating medication dispensing registers, which classified the act of getting medications at the pharmacy as "regular" or "irregular". Drug Related Problems (DRP) were identified through the narrative of caregivers and classified according to the Second Granada Consensus. Then, a pharmaceutical orientation chart with information about the therapeutic regimen was applied, in order to function as a guide for issues that influenced adherence.
A total of 43 patients was included, with a mean age of 11.12 years, and 65.1% (n=28) were female. Applying the questionnaire, it was found "highest" adherence in 46.5% (n=20) patients, "moderate" adherence in 48.8% (n=21), and "low" adherence in 4.7% (n=2). Through an analysis of the medication dispensing registers, a lower level of adherence was observed: only 25.6% (n=11) of the participants received "regularly" the medications. Twenty-six DRP was identified, and 84.6% (n=22) were classified as real. There were no significant associations between socio-demographic variables and adherence, although some caregivers have reported difficulty in accessing the medicines and in understanding the treatment.
Our findings showed problems in the adherence process related to inattention, forgetfulness and irregularity in getting medicines, reinforcing the need for the development of strategies to facilitate a better understanding of treatment and to ensure adherence.
本研究旨在调查在巴西东北部一家三级医院的门诊药房就诊的青少年特发性关节炎患者的药物治疗依从性。
通过与照料者一起，使用基于莫里isky、格林和莱文的结构化问卷进行依从性分析，该问卷能够将依从性分为“高”、“中”或“低”等级，并通过评估药物配药记录，将在药房取药行为分类为“规律”或“不规律”。通过照料者的叙述识别药物相关问题（DRP），并根据第二届格拉纳达共识进行分类。然后应用一份包含治疗方案信息的药学指导图表，作为影响依从性问题的指南。
共纳入43例患者，平均年龄11.12岁，65.1%（n = 28）为女性。应用问卷发现，46.5%（n = 20）的患者依从性为“高”，48.8%（n = 21）为“中”，4.7%（n = 2）为“低”。通过对药物配药记录的分析，观察到依从性较低：只有25.6%（n = 11）的参与者“规律”取药。识别出26个DRP，84.6%（n = 22）被归类为实际问题。社会人口统计学变量与依从性之间无显著关联，尽管一些照料者报告在获取药物和理解治疗方面存在困难。
我们的研究结果显示，在依从过程中存在与注意力不集中、遗忘和取药不规律相关的问题，这进一步表明需要制定策略，以促进对治疗的更好理解并确保依从性。
