Avaliação da adesão ao tratamento ambulatorial de doenças respiratórias crônicas no ambulatório de pneumologia no Centro de Especialidades Clinicas Médicas do CESUPA

Abstract

Objective: To evaluate the impacts of non-adherence in relation to treatment measures for the control of chronic pulmonary diseases in patients under clinical-ambulatory follow-up at the Medical Specialties Center of Cesupa with follow-up time greater than 1 year. Methodology: This is a cross-sectional descriptive observational study, with a qualitative approach and based on the submission of a form in patients with chronic pneumopathology follow-up, seen at the pulmonology outpatient clinic of the Medical Specialties Center of Cesupa, conducted from August 2020 to March 2021. Results: Sixty-nine patients were included in the study. Approximately 70% were female, 60% were 51 to 70 years old. Age ranged from 22 to 89 years, with a mean age of 58 years ± 15 years. The form covers information such as age, gender, education, underlying disease, type of medication, impairment of daily activities, and objective questions about predictors of adherence. Asthma was the most prevalent disorder, followed by COPD and idiopathic pulmonary fibrosis, in equal distribution. 61% of the patients used oral medications, against 58% who used inhaled medications. The forms bring information about the degree of impairment of activities of daily living, in which 55 of the 69 participants reported moderate or high level of impairment, as well as, the level of instruction received by the attending physician, in which most patients claim to have received the necessary guidance for clinical follow-up. About the characteristics of adherence to treatment, 87% of patients said they depend on the treatment to maintain their health, 52% reported that they have already had losses with the treatment due to the costs. The adaptation to the routine of life, the fear of dependence and side effects, and forgetting to take medications were also reported, although with less expressive numbers. Few patients, proportionally, reported having abandoned the treatment for dismissing its necessity or that there is no improvement in their clinical picture. Conclusion: There are several factors that influence drug adherence to chronic lung disease treatment, ranging from financial difficulties, which is a problem in our country, to low levels of education, which directly influences the understanding of the underlying disease and the proposed therapy, and even clarification on how to use the medication, since there may be a need for inhalation devices that have particularities in their use. All these factors can be addressed through appropriate public policies.