Adesão ao tratamento de manutenção em asma (estudo ADERE)

Abstract

Objective: To determine the rate of compliance with preventive treatment of moderate and severe persistent asthma. Methods: Physicians at various medical centers across the country were invited to nominate patients for participation in the study. Inclusion criteria were being over the age of 12 and presenting moderate or severe persistent asthma. Participating patients received salmeterol/fluticasone 50/250 µg by dry powder inhaler for 90 days and were instructed to return the empty packages at the end of the study as a means of determining the total quantity used. In order to evaluate compliance, a member of the research team contacted each patient via telephone at the study outset and again at the end of the 90-day study period. Asthma patients were considered compliant with the treatment if they used at least 85% of the prescribed dose. The following variables were studied: gender, age, race, marital status, years of schooling, smoking habits, other atopic conditions, comorbidities, asthma severity, use of other medication and number of hospital admissions for asthma. Results: A total of 131 patients from fifteen states were included. The overall rate of compliance was found to be 51.9%. There was a significant difference in compliance in relation to asthma severity: compliance was greater among patients with severe persistent asthma than among those with moderate persistent asthma (p = 0.02). There were no statistically significant differences among any of the other variables. Conclusion: The overall rate of compliance with maintenance treatment of asthma was low.

Adherence to Treatment in Severe Asthma

“…Similar studies showed frequencies that vary from 30% to 70% [12]. In a national multicenter study that evaluated 131 people with asthma, Chatkin et al observed asthma therapy adherence in 51.9% of the patients [4]. …”

“…The authors also showed that the most severe asthma symptoms were associated with higher adherence to asthma therapy [4]. The reasons for patient's nonadherence are complex and are frequently related to patients themselves, health care professionals, the health care system, medications, and inhalation devices.…”

Adesão ao tratamento fonoaudiológico segundo a visão de ortodontistas e odontopediatras

“…Cabe ressaltar que os odontopediatras de Itabira A maior causa levantada no estudo para a não adesão ao tratamento fonoaudiológico foi falta de tempo. Apesar do real excesso de atividades das quais as crianças nos dias atuais participam, e do fato de muitos pais não terem disponibilidade, em decorrência da jornada de trabalho, a gravidade da doença, o gênero e a restrição econômica são os fatores considerados na literatura para adesão/não adesão ao tratamento fonoaudiológico (13) . Entretanto, os pacientes podem omitir a verdadeira razão para não procurarem o tratamento indicado, uma vez que os próprios pesquisados relataram que aqueles com boas condições financeiras geralmente aderem à fonoterapia.…”

Causas de óbitos entre asmáticos graves admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia

“…(1,4,21) The lack of asthma control in this subgroup of patients can be attributed to various factors: denial or underestimation of the disease by the patients; insufficient treatment for the severity of the disease; lack or incorrect use of asthma medications; limited access to health care services; presence of comorbidities; and factors inherent to the disease. (21)(22)(23)(24)(25)(26)(27)(28) Some authors have found that the use of inhaled corticoids is inversely proportional to the risk of death from asthma. (3) In the present study, we found that mortality was more common during the first 12 months of treatment for asthma, which suggests that the anti-inflammatory treatment period might have been cumulatively insufficient.…”