Adesão ao tratamento da malária e fatores contribuintes

Abstract

Estudo exploratório, descritivo, transversal. O objetivo foi estimar a frequência de adesão ao tratamento da malária no distrito de Três Fronteiras, município de Colniza, Mato Grosso, descrevendo os fatores que contribuem para a sua ocorrência. Participaram 27 pacientes selecionados na busca ativa. A coleta de dados foi por meio de entrevista e a medida de adesão ao tratamento deu-se pelo autorrelato e contagem de medicamentos. A frequência de adesão foi de 77,8%. Entre os fatores que contribuíram para a adesão ao tratamento da malária, destacaram-se os relacionados ao paciente, principalmente o desejo de melhorar e a confiança na efetividade dos medicamentos. A frequência de adesão encontrada foi ligeiramente inferior à de outros estudos realizados em regiões endêmicas do país. Concluindo, ações de educação em saúde sobre a necessidade de adesão ao tratamento devem ser enfatizadas e intensificadas para minimizar ou eliminar o abandono de tratamento.

Methods to Assess Adult and Adolescent Patients’ Adherence to Antimalarial Treatment: A Systematic Review

“…The sample size described in the studies varied from 27 to 300 participants for the observational/quasi-experimental studies and from 50 to 324 participants for the experimental ones. The patient populations were children and adults, and nine (42.9%) studies excluded pregnant women ( Fungladda et al, 1998 ; Lemma et al, 2011 ; Ferreira et al, 2014 ; Minzi et al, 2014 ; Osorio-de-Castro et al, 2015 ; Souza et al, 2016 ; Saravu et al, 2018 ; Oduro et al, 2019 ; Rosa et al, 2020 ). The eligible studies assessed adherence to antimalarials prescribed for the treatment of malaria caused by P. vivax (10/21, 47.6%) and P. falciparum (16/21, 76.2%).…”

“…The indirect methods described were self-reports, pill counts, MEMS, and clinical cure. To measure adherence to antimalarial treatment, 76.2% (16/21) of the studies used a combination of methods, the most frequent of which were self-reported adherence and pill counts ( Fungladda et al, 1998 ; Lemma et al, 2011 ; Tun et al, 2012 ; Almeida et al, 2014 ; Ferreira et al, 2014 ; Osorio-de-Castro et al, 2015 ; Souza et al, 2016 ; Saravu et al, 2018 ; Takahashi et al, 2018 ; Oduro et al, 2019 ; Bagchi et al, 2020 ) ( Supplementary Table S2 and Table 1 ).…”

“…Five studies included detailed descriptions of the questionnaires/interviews ( Rocha, 2008 ; Almeida et al, 2014 ; Ferreira et al, 2014 ; Souza et al, 2016 ; Rosa et al, 2020 ). Two studies used a single question to assess adherence.…”

“…Two studies used a single question to assess adherence. The question was “Could you take the prescribed medications?” and patients who answered “yes” were considered adherent and those responding “no”, non-adherent ( Ferreira et al, 2014 ; Souza et al, 2016 ). Another study ( Almeida et al, 2014 ) developed a 5-item questionnaire by adding the following question to Morisky’s 4-item instrument ( Morisky et al, 1986 ): “Do you replicate the dose when you are feeling sick?” The patients’ responses to this question were evaluated using both a dichotomous yes/no scale and a Likert scale (“all the time”, “nearly always”, “usually”, “sometimes”, “once a while”, and “never”).…”

“…Furthermore, the articles utilized distinct models for following up with patient’s post-treatment. In the majority of studies (11/21, 52.4%), follow-up took the form of home visits ( Fogg et al, 2004 ; Asante et al, 2009 ; Lemma et al, 2011 ; Tun et al, 2012 ; Almeida et al, 2014 ; Ferreira et al, 2014 ; Minzi et al, 2014 ; Osorio-de-Castro et al, 2015 ; Souza et al, 2016 ; Takahashi et al, 2018 ; Oduro et al, 2019 ). In six studies, the patient was required to return to the clinic ( Na-Bangchang et al, 1997 ; Fungladda et al, 1998 ; Rocha, 2008 ; Cheoymang et al, 2015 ; Steury, 2016 ; Saravu et al, 2018 ), whereas three studies did not report where the follow up took place ( Amponsah et al, 2015 ; Bagchi et al, 2020 ; Rosa et al, 2020 ).…”