Adherence to treatment in collective multiprofessional activities and factors associated with adherence in a specialized center for psychosocial care

Abstract

Introduction: Specialized psychosocial care centers (Centros de Atenção Psicossocial [CAPS]) are mental health services focused on social rehabilitation and reducing hospitalization of patients with severe and persistent mental illness. Collective multiprofessional activities (CMPA) are the main therapeutic tools used at CAPS. This study aimed to determine rates of adherence to CMPA and identify factors associated with adherence. Methods: This is a cross-sectional study in which 111 CAPS users were evaluated using questionnaires covering patient characteristics, clinical status, and treatment and incorporating the Functioning Assessment Short Test (FAST), the Clinical Global Impression-Severity scale (CGI-S), and the Clinical Global Impression-Improvement scale (CGI-I). Adherence was defined as attendance at 50% or more CMPA during the previous 3 months. Data were analyzed using descriptive statistics, bivariate analysis, and Poisson logistic regression with robust variance to estimate prevalence ratios. Results: CPMA adherence was 43%. Having children aged 14 years or younger was significantly associated with non-adherence (71%, p = 0.001). Poor or partial adherence to psychotropic drugs tended to be associated (p = 0.066) with poor adherence (33% higher risk), as was the number of psychiatric hospitalizations during CAPS (p = 0.076), with a cumulative association of 5% non-adherence per hospitalization. Conclusions: CMPA adherence was low in the study. It is necessary to consider the environment in which the individual lives and invest in support networks, providing patients and family members with explanations about the importance of CMPA to rehabilitation and attempting to tailor the care provided to each patient's needs. There was an association between greater number of psychiatric hospitalizations and non-adherence, suggesting that CAPS are fulfilling a preventive role.

As equipes multidisciplinares como dispositivos “técnicos de referência” em saúde mental nos caps e a gestão do cuidado: uma revisão integrativa de literatura

“…Na categoriza "Falta de utilização da equipe multidisciplinar em preferência a utilização de medicamentos" (f=6,66%), utilizando o modelo de atividades multiprofissionais coletivas (CMPA), notou-se que a falta de utilização das equipes multidisciplinares dentro dos CAPS por motivos como a infraestrutura, inadequação dos profissionais e reluta dos pacientes, direcionam os pacientes, por desejarem um resultado mais rápido, a optarem por tratamentos com utilização de medicamentos mais agressivos, visando atenuar ou conter a enfermidade mental que enfrentam (Tergolina et al, 2020).…”