Factores relacionados con la no adherencia al tratamiento farmacológico en hipertensos del Policlínico XX Aniversario. Diseño de un programa educativo
Fecha
2015-06-25
Autores
Jiménez Hernández, Liset
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Editor
Universidad Central “Marta Abreu” de Las Villas. Centro de Bioactivos Químicos.
Resumen
Se realizó una investigación de corte transversal con el objetivo de determinar la relación entre los factores que influyen en el cumplimiento del régimen terapéutico y la no adherencia al tratamiento farmacológico en los pacientes hipertensos del área de salud del policlínico XX Aniversario de la ciudad de Santa Clara y se diseñó un Programa Educativo con el fin de mejorar dicha adherencia. La investigación se realizó de febrero del 2014 hasta febrero del 2015. Se revisaron los certificados de medicamentos controlados y las historias de salud individuales de 510 pacientes seleccionándose una muestra aleatoria de 102 hipertensos con tratamiento farmacológico. Se efectuó una entrevista individual para evaluar la adherencia al tratamiento (test Morisky-Green-Levine). Se tomó la tensión arterial y se indagó sobre otros datos de interés. Fueron escogidos 10 médicos vinculados a la atención primaria a quienes se les aplicó un cuestionario para evaluar su conocimiento sobre la hipertensión arterial y su tratamiento. Para el análisis estadístico se utilizó la prueba de independencia de Chi cuadrado y U de Mann Whitney, con un nivel de significación de p < 0.05. La cifra de hipertensos sin adherencia al tratamiento farmacológico en la muestra seleccionada representó el 58,8%. Esta situación fue más frecuente en los hipertensos que tenían algún factor de riesgo cardiovascular, pertenecientes al sexo femenino, mayores de 50 años, sin tener significación estadística; mientras que el seguimiento incorrecto, la prescripción inadecuada y los profesionales con insuficientes conocimientos sobre hipertensión arterial y su terapéutica contribuyeron a la falta de adherencia al tratamiento hipotensor. Finalmente se diseñó un programa educativo a partir de las deficiencias encontradas, el cual quedó conformado por dos plegables y una charla educativa para los pacientes y un curso de postgrado para los médicos.
The research was carried out of traverse court with the objective of determining the relationship among the factors that influence in the execution of the therapeutic régime and the non-adherence to the pharmacological treatment in the hypertensive patients of the health´s area in the XX Anniversary Clinic of Santa Clara's city to propose an Educational Program that improves this adherence. The investigation was carried out in from February 2014 to February 2015. The certificates of controlled medications and health individual histories of 510 patients were revised being selected a random sample of 102 hypertensive patients with pharmacological treatment. An individual interview was made to evaluate the adherence to treatment (Morisky-Green-Levine test). It was made taking of arterial tension and one investigated on other data of interest. 10 doctors were chosen linked to the primary attention to who were applied a questionnaire to evaluate their knowledge on the arterial hypertension and their treatment. In the statistical analysis of independence of squared Chi test was used and U of Mann Whitney, as significance level, p <0.05. The hypertensive patients figure without adherence to the pharmacological treatment in the selected sample represented 58,8%. The non-adherence to the treatment was more frequent in the hypertensive patients with some factor of cardiovascular risk, belonging to the feminine sex, bigger than 50 years, without having statistical significance; while the incorrect pursuit, the inadequate prescription and the professionals with insufficient knowledge have more than enough arterial hypertension and their therapy they contributed to the lack of adherence to the hipotensor treatment. Finally an educational program was designed starting from the opposing deficiencies, which was conformed by two folding and an educational chat for the patients and course for the doctors.
The research was carried out of traverse court with the objective of determining the relationship among the factors that influence in the execution of the therapeutic régime and the non-adherence to the pharmacological treatment in the hypertensive patients of the health´s area in the XX Anniversary Clinic of Santa Clara's city to propose an Educational Program that improves this adherence. The investigation was carried out in from February 2014 to February 2015. The certificates of controlled medications and health individual histories of 510 patients were revised being selected a random sample of 102 hypertensive patients with pharmacological treatment. An individual interview was made to evaluate the adherence to treatment (Morisky-Green-Levine test). It was made taking of arterial tension and one investigated on other data of interest. 10 doctors were chosen linked to the primary attention to who were applied a questionnaire to evaluate their knowledge on the arterial hypertension and their treatment. In the statistical analysis of independence of squared Chi test was used and U of Mann Whitney, as significance level, p <0.05. The hypertensive patients figure without adherence to the pharmacological treatment in the selected sample represented 58,8%. The non-adherence to the treatment was more frequent in the hypertensive patients with some factor of cardiovascular risk, belonging to the feminine sex, bigger than 50 years, without having statistical significance; while the incorrect pursuit, the inadequate prescription and the professionals with insufficient knowledge have more than enough arterial hypertension and their therapy they contributed to the lack of adherence to the hipotensor treatment. Finally an educational program was designed starting from the opposing deficiencies, which was conformed by two folding and an educational chat for the patients and course for the doctors.
Descripción
Palabras clave
Policlínico XX Aniversario, Programa Educativo, Hipertensión, Hypertension