Avaliação da complexidade da farmacoterapia e da adesão ao tratamento em diabéticos acompanhados em uma Unidade Básica de Saúde

Abstract

Diabetes Mellitus is a disease of clinical and epidemiological importance in our country, adherence to treatment is considered one of the main barriers for the -achievement of the therapeutic goals in the diabetic population, which presents a non-adherence superior to 50%. Medication regimen complexity is indicated as one of the main factors related to non-adherence to treatment in chronic diseases, and it is suggested that it is linked with poorer glycemic control, increasing the incidence of complications. An observational, exploratory cross-sectional study was developed which evaluated the medication regimen complexity and adherence to treatment in patients with Diabetes followed at a Pharmaceutical Care Unit in Fortaleza, Ceará. Adherence to treatment and medication regimen complexity were measured using the Measure of Treatment Adherence and the Medication Regimen Complexity Index questionnaires, respectively, while other data were collected from medical records kept in the unit. Data analysis was performed using the Statistic Package for Social Sciences, version 20.0 for Windows. The population in the study was 67 patients, among whom there was a predominance of females (79.10%); the average age of the population was 59.40 years (± 10.38) with a majority (> 70%) that did not complete high school and received less than two minimum wages. The clinical data collected revealed a mean blood glucose level of 181.06 mg / dL (± 86.59), a mean glycated hemoglobin of 8.06% and an average of 8 years since diagnose. Analyzing the measure of adherence of the population, 70.15% of the patients were classified as adherents to the treatment, with a mean adhesion score of 35.08 (± 3.85). Concerning the pharmacotherapy, 85.71% of patients were identified as polymedicated with an average of 7 (± 2.53) medications per patient and an average MRCI of 18.23 (± 7.16). A comparison between the number of polymedicated patients and those with elevated MRCI revealed that people who are not polymedicated have a fourfold chance to present low MRCI. Comparisons between adherence and MRCI scores, and between adherence scores and number of medications used per patient, resulted in values of p < 0.05. This result may be related to an overestimation of adherence, since the population is outside of the recommended therapeutic goals, indicating a likely non-adhesion therapy. Therefore, a relationship between MRCI and adherence to treatment should not be ruled out.