Adherence to medication before and after the use of a Drug-Dispensing System with usage control

Abstract

The aim of the present work was to assess the adherence to medication from polymedicated patients before and after the use of a Drug-dispensing System with Usage Control (DDSUC) and compare the levels of the clinical parameters -blood pressure, postprandial glycemia, glycated hemoglobin, triglycerides and cholesterol. DDSUC consisted of a monthly drug-dispensing package, in the shape of a blister with a calendar. This quasi-experimental study was performed in a Basic Health Unit. Twenty four patients were selected to use DDSUC for 4 months. Medication adherence was assessed through Morisky-Green test. Among the participants of the study, 62.5% were women and the average age was 67 years old. Before the use of DDSUC, 83.3% of the patients were considered as "less adherent". After the use of the system, 100% were considered as "more adherent" (p < 0.01), the means of the systolic blood pressure decreased 23.7 mmHg (p=0.000), the diastolic blood pressure decreased 12.1 mmHg (p=0.004) and glycemia diminished 79.3 mg/dl (p=0.000). The use of DDSUC improved the adherence to medication and decreased the values of the clinical parameters, making patients safer when it comes to respecting the correct use of their medication.Uniterms: Medication/treatment adherence. Medicines/safety use. Medicines/dispensing. DrugDispensing System and Use Control. Polymedication.O objetivo deste estudo foi avaliar a adesão ao tratamento medicamentoso de pacientes polimedicados antes e após o uso de um Sistema de Dispensação de Medicamentos e Controle de Uso (SDMCU) e comparar os níveis dos parâmetros clínicos -pressão arterial, glicemia pós-prandial, hemoglobina glicada, triglicérides e colesterol. O SDMCU foi constituído por uma embalagem mensal de dispensação de medicamentos, em forma de blister com calendário. Este estudo, do tipo quase-experimental, foi realizado em uma Unidade Básica de Saúde. Selecionaram-se 24 pacientes para utilizar o SDMCU por 4 meses. A adesão medicamentosa foi avaliada através do Teste de Morisky e Green. Entre os participantes do estudo, 62,5% eram mulheres e a idade média foi de 67 anos. Antes do uso do SDMCU, 83,3% dos pacientes foram considerados "menos aderentes". Após o uso do sistema, 100% foram considerados "mais aderentes" (p<0,01), a média da pressão arterial sistólica diminuiu 23,7 mmHg (p=0,000), a diastólica diminuiu 12,1 mmHg (p=0,004) e a glicemia diminuiu 79,3 mg/dL (p=0,000). O uso do SDMCU melhorou a adesão medicamentosa e diminuiu os valores dos parâmetros clínicos, proporcionando aos pacientes uma segurança no que diz respeito à utilização correta de seus medicamentos.Unitermos: Medicação/adesão ao tratamento. Medicamentos/uso seguro. Medicamentos/dispensação.

The use of an electronic medication organizer device with alarm to improve medication adherence of older adults with hypertension

“…Some studies using a blister-calendar pack as reminder for hypertensive diabetic patients have reported similar results. (9,15) Hence, the use of Supermed seems to be a good strategy to increase medication adherence in older adults, who, sometimes, do not take medicines correctly due to forgetfulness and/or functional limitations, such as difficulty to open the packs, read the labels, and understand the healthcare professionals' instructions. (16,17) The World Health Organization (WHO) highlights that inappropriate adherence to long-term therapies is a serious problem worldwide, and that the mean adherence rate in developed countries is 50%, while in developing countries the rates are lower.…”

“…The strategies that clinical pharmacists may adopt to improve medication adherence include providing instructions to patients about their disease, treatment, and lifestyle; monitoring and recording blood pressure; providing medication reminders, including phone calls; and furnishing dispensing systems, such as electronic monitoring, blisters or pillboxes to organize daily doses. (7)(8)(9) In Brazil, there are some daily and weekly medicine box organizers, equipped with alarm clocks, but not an electronic monthly organizer device.…”

Low Scores in the Auto-Compliance Method and Fast Medical Care Influence the Poor Adherence in Diabetics attended in the Basic Health Unit

“…(5) Do you know the long-term benefits of taking your medicine? (6) At times do you forget to replace your medicine before it finishes? The patient only answers questions five and six if they answer yes to all of the questions one to four.…”

“…Nonadherence is a multifactorial problem caused by factors related to the patient, the condition, type of therapy prescribed, the health system and socioeconomic factors. However, there are few studies in the Brazilian public health systems assessing, the effect of complexity of pharmacotherapy, added to the increase in the drug loads in the poor medication adherence in diabetic patients [5,6].…”

Fatores associados com a não adesão à farmacoterapia em pacientes com diabetes atendidos em uma unidade básica de saúde

“…Entretanto, vários estudos encontrados na literatura reportam taxas de não adesão à farmacoterapia em pacientes com DM entre 15-88%(DAVIES et al,2013; PEYROT et al,2012). Vários estudos no mundo inteiro estão analisando os fatores que contribuem para aumentar a adesão ao tratamento em pacientes com T1DM e T2DM(PERES et al, 2017; AHMED et al, 2014;VIEIRA et al, 2015), entretanto, poucos estudos em pacientes atendidos no SUS (Sistema Único de Saúde) foram feitos atualmente. Alguns fatores associados com a baixa adesão ao tratamento como o conhecimento sobre a terapêutica, complexidade da farmacoterapia, drug load ainda são pouco estudados nesses pacientes.…”