Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

Main Article Content

Yuri Barbosa Araújo
https://orcid.org/0000-0002-1724-3637
Jadyelle dos Santos Teixeira
https://orcid.org/0000-0001-5576-0419
Emanuel Cardoso de Oliveira
https://orcid.org/0000-0002-1801-7391
Glebson Santos Sobral
https://orcid.org/0000-0002-3835-7916
Rafael Alexandre Meneguz-Moreno
https://orcid.org/0000-0001-8274-1547
Ricardo Guimarães Amaral
https://orcid.org/0000-0002-9266-6840
Sandra Lauton Santos
https://orcid.org/0000-0003-3373-3254
Luciana Nalone Andrade
https://orcid.org/0000-0002-5481-4355

Abstract

Objective: To assess adherence to antihypertensive treatment in patients at a Family Health Strategy (FHS) unit. Methods: quantitative, transversal, and observational study with 131 hypertensive patients registered in the HIPERDIA program of an FHS located in the city of Lagarto, Sergipe, Brazil, through the analysis of medical records and the application of structured questionnaires. The assessment of the degree of adherence was carried out through the Brief Medication Questionnaire. Results: Factors related to poor adherence were illiteracy (PR: 0.61; 95%CI: 0.42 - 0.89), per capita family income < 1 minimum wage (PR: 0.51; 95%CI : 0.33 - 0.78) and high pharmacological complexity (PR: 0.66; 95%CI: 0.45 - 0.97), while only regular physical activity (PR: 2.64; 95%CI: 1.28 - 5.46) and a good quality of life (PR: 1.44; 95%CI: 1.02 - 2.04) remained positively associated with adherence. Conclusion: As these are modifiable factors, the simplification of the therapeutic scheme and the regular practice of physical activity are key points for increasing adherence to the treatment of systemic arterial hypertension in Primary Care.



Article Details

How to Cite
1.
Araújo YB, Teixeira J dos S, Oliveira EC de, Sobral GS, Meneguz-Moreno RA, Amaral RG, et al. Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program. HSJ [Internet]. 2022 Jun. 26 [cited 2024 Nov. 4];12(2):35-42. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1270
Section
ORIGINAL ARTICLE
Author Biographies

Yuri Barbosa Araújo, Federal University of Sergipe

Fifth-year medical student at Federal University of Sergipe.

Jadyelle dos Santos Teixeira, Federal University of Sergipe

Fifth-year medical student at Federal University of Sergipe.

Emanuel Cardoso de Oliveira, Federal University of Sergipe

Fifth-year medical student at Federal University of Sergipe.

Glebson Santos Sobral, Federal University of Sergipe

Fifth-year medical student at Federal University of Sergipe.

Rafael Alexandre Meneguz-Moreno, Federal University of Sergipe

Professor of Medicine in Federal University of Sergipe, PhD in Sciences at Instituto Dante Pazzanese de Cardiologia, University of Sao Paulo.

Ricardo Guimarães Amaral, Federal University of Sergipe

Postdoctoral Student in Physiological Sciences at Federal University of Sergipe. Doctorate in Physiological Sciences.

Sandra Lauton Santos, Federal University of Sergipe

Professor at the Department of Physiology at the Federal University of Sergipe Federal. Doctorate in Biochemistry and Immunology.

Luciana Nalone Andrade, Federal University of Sergipe

PhD in Biotechnology by RENORBIO-SE (Preclinical Pharmacology and Chemistry of Natural Products) by the Federal University of Sergipe (UFS) and Master in Pharmaceutical Sciences (Pharmacology of Natural Products) by the Federal University of Sergipe.

References

Ribeiro ÍJS, Boery RN de O, Casotti CA, Freire IV, Boery EN. Qualidade de Vida de hipertensos atendidos na Atenção Primária à Saúde. Saúde Debate. 2015;39(105):432-40. https://doi.org/10.1590/0103-110420151050002011

Leite SN, Vasconcellos MPC. Adesão à terapêutica medicamentosa: elementos para a discussão de conceitos e pressupostos adotados na literatura. Cien Saude Colet. 2003;8(3):775-82. https://doi.org/10.1590/S1413-81232003000300011

Gewehr DM, Bandeira VAC, Gelatti GT, Colet CF, Oliveira KR. Adesão ao tratamento farmacológico da hipertensão arterial na Atenção Primária à Saúde. Saúde Debate. 2018;42(116):179-90. https://doi.org/10.1590/0103-1104201811614

Strelec MAAM, Pierin AMG, Mion Jr. D. The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake. Arq Bras Cardiol. 2003;81(4):349-54. https://doi.org/10.1590/S0066-782X2003001200002

Busnello RG, Melchior R, Faccin C, Vettori D, Petter J, Moreira LB, et al. Characteristics associated with the dropout of hypertensive patients followed up in an outpatient referral clinic. Arq Bras Cardiol. 2001;76(5):349-54. https://doi.org/10.1590/S0066-782X2001000500001

Melchiors AC, Correr CJ, Fernández-Llimos F. Tradução e validação para o Português do medication regimen complexity index. Arq Bras Cardiol. 2007;89(4):210-8.

https://doi.org/10.1590/S0066-782X2007001600001

Melchiors AC, Correr CJ, Pontarolo R, Santos FODS, Paula e Souza RA. Qualidade de vida em pacientes hipertensos e validade concorrente do Minichal-Brasil. Arq Bras Cardiol. 2010;94(3):357-64. https://doi.org/10.1590/S0066-782X2010000300013

Ferreira MA, Iwamoto HH. Determinants of adherence to treatment of hypertension patients registered in the hiperdia program of the primary health care. REME Rev Min Enferm. 2017;21:e1037. https://doi.org/10.5935/1415-2762.20170047

Girotto E, Andrade SM, Cabrera MAS, Matsuo T. Adesão ao tratamento farmacológico e não farmacológico e fatores associados na atenção primária da hipertensão arterial. Cienc Saude Colet. 2013;18(6):1763-72. https://doi.org/10.1590/S1413-81232013000600027

Santa-Helena ET, Nemes MIB, Neto JE. Fatores associados à não-adesão ao tratamento com anti-hipertensivos em pessoas atendidas em unidades de saúde da família. Cad. Saude Publica. 2010;26(12):2389-98. https://doi.org/10.1590/S0102-311X2010001200017

Barreto MS, Matsuda LM, Marcon SS. Factors associated with inadequate blood pressure control in patients of primary care. Esc Anna Nery - Rev Enferm. 2016;20(1):114-20. https://doi.org/10.5935/1414-8145.20160016

Mantovani MF, Mattei AT, Arthur JP, Ulbrich EM, Moreira RC. Utilização do Brief Medication Questionnaire na adesão medicamentosa de hipertensos. Rev Enferm UFPE. 2015;9(1):84-90.

Barreto MS, Reiners AAO, Marcon SS. Conhecimento sobre hipertensão arterial e fatores associados à não adesão à farmacoterapia. Rev Latino-Am Enferm. 2014;22(3):491-498. https://doi.org/10.1590/0104-1169.3447.2442

Tavares NUL, Bertoldi AD, Thumé E, Facchini LA, França GVA, Mengue SS. Factors associated with low adherence to medication in older adults. Rev Saude Publica. 2013;47(6):1092-101. https://doi.org/10.1590/S0034-8910.2013047004834

Souza CS, Stein AT, Bastos GAN, Pellanda LC. Blood pressure control in hypertensive patients in the "hiperdia program": A territory-based study. Arq Bras Cardiol. 2014;102(6):571-8. https://doi.org/10.5935/abc.20140081

Schmitt Júnior AA, Lindner S, Santa Helena ET. Assessment of adherence in elderly patients in primary care. Rev Assoc Med Bras. 2013;59(6):614-21. https://doi.org/10.1016/j.ramb.2013.06.016

Kasper M, Vargas T, Santos A, Raasch J, Betti A, Perassolo M. Adesão à terapia medicamentosa e qualidade de vida de usuários de uma unidade de saúde da família de Novo Hamburgo - RS. Rev Bras Farm Hosp Serv Saúde. 2017;08(04):11-7. https://doi.org/10.30968/rbfhss.2017.084.003

Carvalho ALM, Leopoldino RWD, Silva JEG, Cunha CP. Adesão ao tratamento medicamentoso em usuários cadastrados no Programa Hiperdia no município de Teresina (PI). Cien Saude Colet. 2012;17(7):1885-92. https://doi.org/10.1590/S1413-81232012000700028

Tavares NUL, Bertoldi AD, Mengue SS, Arrais PSD, Luiza VL, Oliveira MA, et al. Factors associated with low adherence to medicine treatment for chronic diseases in brazil. Rev Saude Publica. 2016;50(supl 2):10s. https://doi.org/10.1590/s1518-8787.2016050006150

Maciel APF, Pimenta HB, Caldeira AP. Quality of life and medication adherence in hypertensive patients. Acta Paul Enferm. 2016;29(5):542-8. https://doi.org/10.1590/1982-0194201600075

Ben AJ, Neumann CR, Mengue SS. The brief medication questionnaire and Morisky-Green test to evaluate medication adherence. Rev. Saude Publica. 2012;46(2):279-89. https://doi.org/10.1590/S0034-89102012005000013

Morgado MP, Morgado SR, Mendes LC, Pereira LJ, Castelo-Branco M. Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: Review and meta-analysis. Am J Heal Pharm. 2011;68(3):241-53. https://doi.org/10.2146/ajhp090656

Contreras-Macías E, Gutiérrez-Pizarraya A, Robustillo Cortés MA, Morillo-Verdugo R. High level of medication regimen complexity index correlate with worse quality of life in people living with HIV. Rev Esp Quimioter. 2021;34(2):93-9. https://doi.org/10.37201/req/097.2020

Garfield S, Clifford S, Eliasson L, Barber N, Willson A. Suitability of measures of self-reported medication adherence for routine clinical use : A systematic review. BMC Med Res Methodol. 2011;11(1):149. https://doi.org/10.1186/1471-2288-11-149

Loyola Filho AI, Uchoa E, Firmo JOA, Lima-Costa MF. Estudo de base populacional sobre o consumo de medicamentos entre idosos: Projeto Bambuí. Cad Saúde Pública. 2005;21(2):545-53. https://doi.org/10.1590/S0102-311X2005000200021

Vasconcelos FF, Victor JF, Moreira MTM, Araújo TL. Utilização medicamentosa por idosos de uma Unidade Básica de Saúde da Família de Fortaleza - CE. Acta Paul Enferm. 2005;18(2):178-83. https://doi.org/10.1590/S0103-21002005000200010

Rozenfeld S. Prevalência, fatores associados e mau uso de medicamentos entre os idosos: uma revisão. Cad Saúde Pública. 2003;19(3):717-24. https://doi.org/10.1590/S0102-311X2003000300004

Demoner MS, Ramos ERP, Pereira ER. Factors associated with adherence to antihypertensive treatment in a primary care unit. Acta Paul Enferm. 2012;25(spe1):27-34. https://doi.org/10.1590/S0103-21002012000800005

Bezerra ASM, Lopes JL, Barros ALBL. Adesão de pacientes hipertensos ao tratamento medicamentoso. Rev Bras Enferm. 2014;67(4):550-5. https://doi.org/10.1590/0034-7167.2014670408

Gomes e Martins A, Chavaglia SRR, Ohl RIB, Martins IML, Gamba MA. Adesão ao tratamento clínico ambulatorial da hipertensão arterial sistêmica. Acta Paul Enferm. 2014;27(3):266-72. https://doi.org/10.1590/1982-0194201400045

Piccini RX, Facchini LA, Tomasi E, Siqueira FV, Silveira DS, Thumé E, et al. Promotion, prevention and arterial hypertension care in Brazil. Rev Saúde Pública. 2012;46(3):543-50. https://doi.org/10.1590/S0034-89102012005000027

Yiannakopoulou EC, Papadopulos JS, Cokkinos DV, Mountokalakis TD. Adherence to antihypertensive treatment: A critical factor for blood pressure control. Eur J Prev Cardiol. 2005;12(3):243-49. https://doi.org/10.1097/01.hjr.0000160601.41762.44

Soares MM, Silva LOL, Dias CA, Rodrigues SM, Machado CJ. Adesão do idoso ao tratamento da hipertensão arterial sistêmica: revisão integrativa. Cogitare Enferm. 2012;17(1):144-50. https://doi.org/10.5380/ce.v17i1.26389

Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADM, et al. Diretrizes Brasileiras de Hipertensão Arterial - 2020. Arq Bras Cardiol. 2021;116(3):516-658. https://doi.org/10.36660/abc.20201238

Rabelo DF, Lima CFM, Freitas PM, Santos JC. Qualidade de vida, condições e auto-percepção da saúde entre idosos hipertensos e não hipertensos. Rev Kairós. 2010;13(2):115-30.

Tavares DMS, Guimarães MO, Ferreira PCS, Dias FA, Martins NPF, Rodrigues LR. Quality of life and accession to the pharmacological treatment among elderly hypertensive. Rev Bras Enferm. 2016;69(1):122-9. https://doi.org/10.1590/0034-7167.2016690118i

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