Fatores Associados à não Adesão ao Tratamento Medicamentoso de Hipertensos em uma Cidade do Interior do Brasil

Abstract

This is an analytical cross-sectional study conducted to identify the factors associated with non-adherence to drug therapy in hypertensive patients cared for at a reference service in a town belonging to the microregion of Southwestern Goiás, Brazil. The case-by-case assessment involved 249 people, aged 18 and older, with a confirmed high blood pressure diagnosis for at least a year. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). The data were collected from December 2014 to August 2015 through analysis of medical records in addition to individual and structured interviews, followed by a descriptive analysis of the variables related to the patients’ socioeconomic status, health, interaction with the staff and health care system, drug therapy, as well as variables related to the patients. In order to identify the factors associated with non-adherence to drug therapy, a univariate logistic regression analysis was conducted. All the independent variables that presented p<0.2 on the univariate analysis entered into a multivariate logistic regression analysis. The average age was 60.5 ± 11.09. The majority were females, 73.9% were not educated beyond elementary school, 42.2% were employed, 49.4% were working class individuals and 69.8% had a partner. The study demonstrated that 72.7% were diagnosed over 10 years ago and 49.8% presented ucontrolled blood pressure. The antihypertensive drugs most commonly prescribed were hydrochlorothiazide and losartan. The average amount of pills taken was 2.18 and 4.12, respectively. Prevalence of non-adherence was 63,4%. The factors that remained associated with nonadherence were: undesired effects (OR=5,54; IC95%: 1,91 – 16,05) and suspension of treatment due to these undesired effects (OR=2,37; IC95%: 1,29 – 4,36). The results indicate high prevalence of nonadherence, which was associated with drug therapy factors.