Regular access and adherence to medications of the specialized component of pharmaceutical services

Abstract

OBJECTIVE To investigate the prevalence of the adherence to the medications of the Specialized Component of Pharmaceutical Services and its association with regular access in users of these medications in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil.METHODS This is a cross-sectional study with adults aged 20 years and over, who are users of medications of the Specialized Component of Pharmaceutical Services. Sampling was carried out consecutively for users who accessed the service of the Specialized Component of Pharmaceutical Services during the period from December 2014 to March 2015. Adherence was measured by the Brief Medication Questionnaire, and adherents were defined as those who did not present barriers to adherence in the three domains. Regular access was defined as getting all medications in the last three months, regardless of how it was obtained (paying or for free). Data analysis was performed using Poisson regression with robust variance.RESULTS We interviewed 414 subjects, being them mostly women (60.9%), with mean age of 55 years (SD = 13), and using a single medication of the Specialized Component of Pharmaceutical Services (68.1%). The prevalence of adherence to the medications used in the last seven days was 28.3% and the prevalence of free regular access was 46.1%, and 25.7% did not have access to all treatment. After adjusting for the number of medications in the Specialized Component of Pharmaceutical Services and the number of medications of continuous use, users who had free regular access in the last three months were 60% more likely to show adherence. For individuals with paid regular access, no association was found between access and adherence.CONCLUSIONS The regularity in the free access to the medications of the Specialized Component of Pharmaceutical Services has an impact on the behavior of users, contributing to their commitment to treatment and self-care. The Specialized Component of Pharmaceutical Services needs programming in order to avoid irregular access, which suggests a significant limitation of the drug policies in Brazil.

Access to medicines for the treatment of chronic diseases in Chile: qualitative analysis of perceived patient barriers and facilitators in five regions of the country

“…It is possible to find experiences of countries in different economic or geographical contexts in this regard (21)(22)(23)(24). In fact, in the Americas region, there are close examples, such as the case of Brazil with the free delivery of medications by the SUS, and its Health Has no Price programs (for hypertension and diabetes as is of interest in this research) and Popular Pharmacies (25)(26)(27)(28). Another barrier that emerges in the study and is also reported in the literature for various countries, such as Barbados, the US and Colombia, relates to the bureaucracy or how complex and cumbersome it is to understand the insurance requirements to obtain medication coverage (29)(30)(31), as happens in Chile to the ISAPRE beneficiaries for the use of GES.…”

“…The copyright holder for this preprint this version posted January (25)(26)(27)(28). Another barrier that emerges in the study and is also reported in the literature for various countries, such as Barbados, the US and Colombia, relates to the bureaucracy or how complex and cumbersome it is to understand the insurance requirements to obtain medication coverage (29)(30)(31), as happens in Chile to the ISAPRE beneficiaries for the use of GES.…”

Efetividade tecnológica na prontidão para mudança comportamental em hipertensão e excesso ponderal

“…(11) Isso significa que eles sabem dos benefícios de modificar o estilo de vida, reconhecem sua importância para a saúde, mas há barreiras que dificultam ou impedem sua adesão como aquelas: relacionadas ao indivíduo -déficit cognitivo, baixa escolaridade, sentimentos de incapacidade, alcoolismo, socioeconômicos, aceitação da doença e esquecimento; ao tratamento -alto custo dos medicamentos, longa duração e complexidade do tratamento, efeitos adversos e número de medicamentos; e à doençacomplicações tardias, assintomatologia, condições da doença e cronicidade, serviços de saúde, insuficiência de informação, dificuldades no acesso e habilidade deficiente dos profissionais para ensinar o uso correto dos medicamentos. (15)(16)(17) Assim, deve-se utilizar a tecnologia individualmente, já que ela tem efeito no estágio de prontidão para mudança como evidenciado nesse estudo, ou em associação com outras tecnologias efetivas, (18,19) pois sabe-se que estudos com melhores impactos na saúde cardiovascular dos participantes são aqueles que trazem a tecnologia em forma de um programa, com múltiplas estratégias envolvidas. (19) Além de proporcionar a identificação do estágio de prontidão para mudança de comportamento e elencar os indivíduos mais propensos a adesão da mudança do estilo de vida, a aplicação da SOC Scale apresenta-se útil para mensurar o efeito das tecnologias educativas sobre o avanço desses está-gios.…”

Avaliação da adesão ao tratamento medicamentoso de pacientes idosos atendidos em um Ambulatório de Geriatria

“…Ao analisarmos a adesão ao tratamento medicamentoso, 35,2% daqueles considerados não aderentes ao tratamento, estão inclusos nesta faixa salarial. A condição socioeconômica representa um fator capaz de interferir na manutenção do tratamento medicamentoso (22) e foi apontada em outros estudos como um agente capaz de influenciar o comprometimento do usuário com seu tratamento, aumentar as chances de descontinuidade da terapia, e por consequência, acarretar uma menor adesão ao tratamento medicamentoso (23)(24)(25).…”