Influential Factors in Adherence to the Therapeutic Regime in Hypertension and Diabetes

Abstract

Objective. To determine the factors associated with adherence to the therapeutic regime in patients with hypertension and type 2 diabetes mellitus cared for in primary care centers.Methods. This was an analytical cross-sectional study, conducted with 500 patients from two institutions in Bucaramanga (Colombia). Adherence to the therapeutic regime was measured with the label of Nursing outcomes “Treatment Behavior: Illness or Injury” and the instrument “Factors that influence on adherence to pharmacological and non-pharmacological treatments” by Ortiz Suárez was used. Results. Factors affecting negatively adherence to the therapeutic regime were: belonging to the subsidized regime, never being able to read written information about the management of their disease, and never receiving information about benefits of the medications ordered by the physician. On the contrary, positive influence was noted by referring “never” to the following statements, which impacted positively on adherence: the diverse occupations you have in and out of the house hinder your following the treatment; when your symptoms improve, do you interrupt the treatment? previously, have you had difficulties in complying with your treatment and believe there are difficult-to-change customs about foods and exercises? Conclusion. Two socioeconomic factors and one related with the health system and staff affected negatively on adherence to the therapeutic regime, while four factors related with the therapy favored it. The factors identified could be used in the design of nursing interventions to improve adherence in this population.Descriptors: treatment adherence and compliance; hypertension; diabetes mellitus, type 2; risk factors; cross-sectional studiesHow to cite this article: Parra DI, Romero SL, Rojas LZ. Influential Factors in Adherence to the Therapeutic Regime in Hypertension and Diabetes. Invest. Educ. Enferm. 2019; 37(3):e02.

Factors Conditioning the Adherence to Pharmacological Prescription in Patients with Hypertension Attending Primary Healthcare Units in Quito – Ecuador

“…The study "Cohort Study of Medication Adherence among Older Adults (CoSMO)" (M. Krousel-Wood et al, 2011) reported very low adherence to medication (14%) in patients older than 65 years of age; these values vary according to age group, sex, and ethnicity (MA Krousel-Wood et al, 2009). In the present study, patients with lower education had lower adherence, which corroborates what was reported by other studies in which a low level of education and reduced knowledge about the disease and treatment were significantly associated with low adherence (Parra et al al., 2019).…”

“…Free access to care in public health services and the formulation of plans and programs aimed at providing permanent and timely access to comprehensive health care, based on the principles established in the Constitution (Constitution of the Republic of Ecuador, 2008), have not always crystallized in benefits provided to patients with chronic diseases who are cared for at the first level. Different authors report an association between low adherence with the following factors of the health care system: not being able to read the written instructions regarding the management of the disease, not receiving information about hypertension, no availability of out-ofpocket expenses to access care and medications, deficiencies in the relationship and communication between patient and their healthcare provider, in addition to a general patient´s perception of receiving poor quality of care (Parra et al, 2019; van der Laan et al, 2017).…”

Factors Affecting Tendency and Adherence to Traditional Persian Medicine: A Qualitative Study

“…In a study, Beena Jimmy et al stated that non-adherence is a common phenomenon in all the patients receiving medicines, and the complexity of this phenomenon is due to the interaction of various factors such as patients' approaches and behavior, disease characteristics, social factors, accessibility, and the quality of services (8). In another study, Parra DI et al evaluated the factors contributing to adherence to therapeutic regimens in hypertension and diabetes and found that health-system related factors could discourage adherence, while some therapy-related factors can promote it (20).…”

Adesão ao autocuidado de pessoas com Diabetes Mellitus na Atenção Primária: estudo de método misto

“…Outros estudos evidenciaram ainda que a motivação intrínseca e o enfrentamento da doença com pensamento positivo têm relação com a adesão à atividade física 4,20 . Quanto às dificuldades financeiras, as pessoas com DM2 têm a convicção de que um melhor poder aquisitivo permite a promoção de uma dieta adequada à sua condição de saúde 5 . A falta de apoio da família também pode ser um dificultador na adesão a estas dimensões do autocuidado 19 .…”

“…A adesão ao autocuidado pode mudar como resultado de circunstâncias inerentes à própria pessoa 3,4 e questões externas que envolvem aspectos sociais 5 e ações realizadas pelo sistema de saúde 6,7 . Nesse sentido, a Atenção Primária à Saúde (APS) tem caráter estratégico para a promoção do autocuidado por meio de um cuidado integral e resolutivo às pessoas com DM2.…”