Adherence to antiretroviral treatment: comprehensive care based on the care model for chronic conditions

Abstract

Objective: To evaluate the adherence to antiretroviral therapy (ART), identifying possible interventions based on the Care Model for Chronic Conditions. Methods: Observational, quantitative, cross-sectional study, involving 215 people with HIV/aids using antiretroviral drugs, between March and June 2012, in Fortaleza, Ceará. From the specific adherence questionnaire, we used nine questions for discussion in the light of the Care Model for Chronic Conditions (MACC). Results: 35.4% failed to adhere to medication at least once. In view of the MACC, gaps were identified, such as the need for more professional intervention, showing possibilities to apply new strategies, such as self-care actions, motivational interviews, operative group and others. Conclusion: A significant percentage of non-adherence to ART was found, whose interventions are still incipient. Actions based on the MACC can favor comprehensive care for patients with HIV/aids. RESUMOO objetivo deste estudo foi avaliar a adesão à terapia antirretroviral (TARV), identificando possibilidades de intervenções embasadas no modelo de atenção às condições crônicas. Métodos: Estudo observacional, quantitativo, transversal, desenvolvido com 215 pessoas com HIV/AIDS em uso de antirretrovirais, entre março e junho de 2012, em Fortaleza, Ceará. De um questionário específico para avaliar a adesão utilizaram-se nove quesitos para discussão à luz do Modelo de Atenção às Condições Crônicas (MACC). Resultados: 35,4% das pessoas estudadas deixaram de aderir ao tratamento pelo menos alguma vez, por se sentirem melhor/ pior, ou tristes/deprimidas. Sob a luz do MACC, foram identificadas lacunas, como necessidade de mais intervenção profissional, evidenciando possibilidades de aplicar novas estratégias, como ações para o autocuidado, entrevista motivacional, grupo operativo,e outras. Conclusão: Constatou-se que há um percentual significativo de não adesão à TARV, cujas intervenções ainda são incipientes,e que ações baseadas no MACC podem favorecer uma assistência totalitária aos pacientes com HIV/AIDS. RESUMENObjetivo: Evaluar la adherencia a la terapia antirretroviral (TARV), identificando las posibles intervenciones basadas en el modelo de atención de las condiciones crónicas. Métodos: Estudio observacional, cuantitativo, transversal, desarrollado con 215 personas con VIH/SIDA con medicamentos antirretrovirales, entre marzo y junio de 2012, en Fortaleza, Ceará. De un cuestionario específico para valorar la adherencia, se utilizaron nueve preguntas para su discusión a la luz del Modelo de Atención a las Condiciones Crónicas (MACC). Resultados: Se observó que 35,4% de los pacientes dejaron de adherir a la medicación por lo menos una vez. A la luz del MACC, fueron identificadas deficiencias, como la necesidad de más intervención profesional, mostrando las posibilidades de implementar nuevas estrategias, como las acciones de autocuidado, entrevista motivacional, grupo operativo y otros. Conclusión: Se encontró un porcentaje significativo de no adherencia al tratamiento...

Adherence to antiretroviral therapy and correlation with adverse effects and coinfections in people living with HIV/AIDS in the municipality of Goiás State

“…This is the first study to describe the level of adherence to ART in the municipality of Anápolis, the third largest municipality in the State of Goiás (370,875 inhabitants/2016). Adherence is a major issue in the management of chronic diseases; for people living with HIV/AIDS, the use of ART at prescribed doses and frequencies guarantees great benefits, such as reduction in the occurrence of opportunistic diseases, reduction in the frequency of hospital admissions, reduction in mortality rates, and consequent increase in the time and treatment life quality [19][20][21][22] .Our results indicated that 85% (188/220) of the participants had good or strict adherence to ART and, considering the entire sample, 85% (77/91) of women and 86% (111/129) of men presented good or strict adherence to ART. These results were discordant compared with those of another study that used CEAT-HIV in the State of Ceará, which presented adherence rates of 14% and 48.7% 20 .…”

Profilaxia da transmissão vertical do HIV: cuidado e adesão desvelados por casais

“…Recommendations and routines for health services and users are implemented (4) , aiming at obtaining good therapeutic results, resulting in the maintenance of adherence to the treatment and prophylactic measures (5)(6) . Although antiretroviral therapy (ART) enables the increased survival of patients (3) and the prevention of infection in some situations, it does not mean it is easy to be performed (7) . We can consider that the adherence to treatment shows itself as something that is constructed and conquered daily, and its effectiveness occurs when there is clarity of the need of treatment (8)(9) , among other issues.…”

Prevalence of the Nursing Diagnosis Lack of Adherence in People Living with AIDS

“…Adherence is characterized as the establishment of a joint activity, in which the patient is not a mere follower of medical guidance, but understands and agrees with the recommended prescription. In the people living with AIDS, the continued use of antiretroviral medications reduces the level of viral load, improving the immune conditioning, and allowing a better quality of life [3]. However, some factors interfere with medication adherence, by the use of alcohol, drugs, socioeconomic conditions and the non-acceptance of the new health condition.…”

“…Understanding such adherence goes through the simple follow-up to the regimen prescribed by health professionals; the identification factors responsible for failures to comply with the treatment are useful, allowing the nurse, as a member of the health team, working more effectively with patients with little adherence and developing strategies to overcome these factors to obtain higher bond rates [2] [3].…”