Calidad de vida y adherencia a la terapia con medicamentos en la atención primaria de salud: enfoque en los trastornos mentales comunes
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Resumen
Introducción. La adherencia al tratamiento farmacológico es un desafío en la práctica clínica de los profesionales de la salud.
Objetivo. Identificar los predictores de la no adherencia a la farma-coterapia y los predictores de la calidad de vida en los usuarios de medicamentos.
Método. Estu-dio analítico transversal realizado en cinco unidades de atención primaria de salud (APS) en Bra-sil. Las herramientas estandarizadas incluyeron el Cuestionario de autoinforme, la Prueba de me-dición de la adherencia al tratamiento y el Resumen de WHOQOL, además de un cuestionario sociodemográfico relacionado con el tratamiento.
Resultados. Los participantes con trastornos mentales comunes (TMC) y que usan psicofármacos fueron más vulnerables a la falta de adheren-cia al tratamiento con medicamentos. Las variables sociodemográficas, la presencia de TMC y el uso de psicofármacos fueron predictores importantes de una peor calidad de vida en los pacientes atendidos en la APS.
Discusión y conclusión. Los hallazgos de este estudio pueden respaldar intervenciones dirigidas a la adherencia al tratamiento farmacológico y capacitar a los profesiona-les de la salud pública para mejorar la atención médica.
Referencias
Ausín, B., Zamorano, A., & Muñoz, M. (2020). Relationship between quality of life and sociodemographic, physical and mental health variables in people over 65 in the community of Madrid. International Journal of Environmental Research and Public Health, 17(22), 1-11. https://doi.org/10.3390/ijerph17228528
Barros, F. C., Matijasevich, A., Santos, I. S., Horta, B. L., da Silva, B. G. C., Munhoz, T. N., Fazel, S., Stein, A., Pearson, R. M., Anselmi, L., & Rohde, L. A. (2018). Social inequalities in mental disorders and substance misuse in young adults: A birth cohort study in Southern Brazil. Social Psychiatry and Psychiatric Epidemiology, 53(7), 717-726. https://doi.org/10.1007/s00127-018-1526-x
Bielderman, A., de Greef, M. H. G., Krijnen, W. P., & van der Schans, C. P. (2015). Relationship between socioeconomic status and quality of life in older adults: a path analysis. Quality of Life Research, 24(7), 1697-1705. https://doi.org/10.1007/s11136-014-0898-y
Brody, D. J., & Gu, Q. (2020). Antidepressant Use Among Adults: United States, 2015-2018. NCHS Data Brief, 377, 1-8.
Caron, J., Cargo, M., Daniel, M., & Liu, A. (2019). Predictors of Quality of Life in Montreal, Canada: A Longitudinal Study. Community Mental Health Journal, 55(2), 189-201. https://doi.org/10.1007/s10597-018-0340-y
Delgado, A. B., & Lima, M. L. (2001). Contributo para a validação concorrente de uma medida de adesão aos tratamentos. Psicologia, Saúde & Doenças, 2(2), 81-100. Retrieved from https://www.researchgate.net/publication/237033567_Contributo_para_a_avalicao_concorrente_de_uma_medida_de_adesao_aos_tratamentos
El Abdellati, K., De Picker, L., & Morrens, M. (2020). Antipsychotic Treatment Failure: A Systematic Review on Risk Factors and Interventions for Treatment Adherence in Psychosis. Frontiers in Neuroscience, 14, 531763. https://doi.org/10.3389/fnins.2020.531763
Estrela, M., Herdeiro, M. T., Ferreira, P. L., & Roque, F. (2020). The use of antidepressants, anxiolytics, sedatives and hypnotics in Europe: Focusing on mental health care in portugal and prescribing in older patients. International Journal of Environmental Research and Public Health, 17(22), 1-12. https://doi.org/10.3390/ijerph17228612
Ferretti, F., Castanha, A. C., Padoan, E. R., Lutinski, J., & Silva, M. R. da. (2018). Quality of life in the elderly with and without chronic pain. Brazilian Journal of Pain, 1(2), 111-115. https://doi.org/10.5935/2595-0118.20180022
Fleck, M. P. A., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., & Pinzon, V. (2000). ApplicationofthePortugueseversion of the abbreviated instrumentof quality life WHOQOL-bref. Revista de Saude Publica, 34(2), 178-183. https://doi.org/10.1590/s0034-89102000000200012
Gast, A., & Mathes, T. (2019). Medication adherence influencing factors - An (updated) overview of systematic reviews. Systematic Reviews, 8(1), 1-17. https://doi.org/10.1186/s13643-019-1014-8
González-Blanch, C., Hernández-de-Hita, F., Muñoz-Navarro, R., Ruíz-Rodríguez, P., Medrano, L. A., & Cano-Vindel, A. (2018). The association between different domains of quality of life and symptoms in primary care patients with emotional disorders. Scientific Reports, 8(1), 1-10. https://doi.org/10.1038/s41598-018-28995-6
Gupta, P., Patel, P., Štrauch, B., Lai, F. Y., Akbarov, A., Marešová, V., White, C. M., Petrák, O., Gulsin, G. S., Patel, V., Rosa, J., Cole, R., Zelinka, T., Holaj, R., Kinnell, A., Smith, P. R., Thompson, J. R., Squire, I., Widimský, J., ... Tomaszewski, M. (2017). Risk Factors for Nonadherence to Antihypertensive Treatment. Hypertension, 69(6), 1113-1120. https://doi.org/10.1161/HYPERTENSIONAHA.116.08729
Ismail, L. M. N., Selim, M. A.-A., & Elkhashab, S. O. Y. (2017). Factors affecting medication adherence among patients with rheumatic disorders. Journal of Nursing Education and Practice, 7(8), 7. https://doi.org/10.5430/jnep.v7n8p7
Jin, H., Kim, Y., & Rhie, S. J. (2016). Factors affecting medication adherence in elderly people. Patient Preference and Adherence, 10, 2117-2125. https://doi.org/10.2147/PPA.S118121
Kim, J., Combs, K., Downs, J., & Tillman III, F. (2018). Medication Adherence: The Elephant in the Room. US Pharmacist, 43(1), 30-34. Retrieved from https://www.uspharmacist.com/article/medication-adherence-the-elephant-in-the-room
Kopp, M., Fleischhacker, W. W., Stürz, K., Ruedl, G., Kumnig, M., & Rumpold, G. (2011). Poor health behaviour and reduced quality of life of people treated with psychotropic drugs. Human Psychopharmacology: Clinical and Experimental, 26(2), 161-167. https://doi.org/10.1002/hup.1190
Kroenke, K., Outcalt, S., Krebs, E., Bair, M. J., Wu, J., Chumbler, N., & Yu, Z. (2013). Association between anxiety, health-related quality of life and functional impairment in primary care patients with chronic pain. General Hospital Psychiatry, 35(4), 359-365. https://doi.org/10.1016/j.genhosppsych.2013.03.020
Lam, W. Y., & Fresco, P. (2015). Medication Adherence Measures: An Overview. BioMed Research International, 2015, 217047. https://doi.org/10.1155/2015/217047
Lee, K. H., Xu, H., & Wu, B. (2020). Genderdifferences in quality of life among community-dwelling older adults in low- and middle-income countries: results from the Study on globalAGEing and adult health (SAGE). BMC PublicHealth, 20(1), 114. https://doi.org/10.1186/s12889-020-8212-0
Magin, P., Tapley, A., Dunlop, A. J., Davey, A., van Driel, M., Holliday, E., Morgan, S., Henderson, K., Ball, J., Catzikiris, N., Mulquiney, K., Spike, N., Kerr, R., & Holliday, S. (2018). Changes in Australian Early-Career General Practitioners’ Benzodiazepine Prescribing: A Longitudinal Analysis. Journal of General Internal Medicine, 33(10), 1676-1684. https://doi.org/10.1007/s11606-018-4577-5
Malhotra, S., & Shah, R. (2015). Women and mental health in India: An overview. Indian Journal of Psychiatry, 57(Supp), 205-211. https://doi.org/10.4103/0019-5545.161479
Mari, J. D. J., & Williams, P. (1986). A Validity Study of a Psychiatric Screening Questionnaire (SRQ-20) in primary care in the city of Sao Paulo. British Journal of Psychiatry, 148, 23-26. https://doi.org/10.1192/bjp.148.1.23
Martin, L. R., Feig, C., Maksoudian, C. R., Wysong, K., & Faasse, K. (2018). A perspective on nonadherence to drug therapy: Psychological barriers and strategies to overcome nonadherence. Patient Preference and Adherence, 12, 1527-1535. https://doi.org/10.2147/PPA.S155971
Miasso, A. I., Telles Filho, P. C. P., Borges, T. L., Pereira Junior, A. C., Vedana, K. G. G., Shasanmi, R. O., & Gimenes, F. R. E. (2017). Quality of Life in Brazil’s Family Health Strategy: Common Mental Disorders, Use of Psychotropic Drugs and Sociodemographic Factors. Archives of Psychiatric Nursing, 31(1), 68-72. https://doi.org/10.1016/j.apnu.2016.08.005
Miasso, A. I., Telles Filho, P. C. P., Borges, T. L., Pereira Júnior, A. C., Vedana, K. G. G., Shasanmi, R., & Escobar Gimenes, F. R. (2016). Adherence to Psychotropic Medications and Associated Factors in Primary Health Care. Issues in Mental Health Nursing, 37(10), 775-783. https://doi.org/10.1080/01612840.2016.1214854
Ogawa, Y., Takeshima, N., Hayasaka, Y., Tajika, A., Watanabe, N., Streiner, D., & Furukawa, T. A.. (2019). Antidepressants Plus Benzodiazepines for Adults with Major Depression. The Cochrane Database of Systematic Reviews, 101(9), 527-528. https://doi.org/10.1002/14651858.CD001026.pub2
Pereira Júnior, A. do C., Miasso, A. I., Telles Filho, P. C. P., Castilho, E. C. D., & Vedana, K. G. G. (2021). Evaluation of Quality of Life of Primary Health Care Patients in Brazil: Influence of Drug Interactions, Common Mental Disorders, and Use of Psychiatric Medication. Community Mental Health Journal, 58(2), 240-248. https://doi.org/10.1007/s10597-021-00815-8
Pino-Sedeño, T. Del, Peñate, W., Cuevas, C. D. Las, Valcarcel-Nazco, C., Fumero, A., Serrano-Pérez, P. G., Acosta-Artiles, F. J., Ramos-García, V., León-Salas, B., Bejarano-Quisoboni, D., & Trujillo-Martín, M. M. (2019). Effectiveness and cost-effectiveness of a multicomponent intervention to improve medication adherence in people with depressive disorders - mapdep: A study protocol for a cluster randomized controlled trial. Patient Preference and Adherence, 13, 309-319. https://doi.org/10.2147/PPA.S172963
Prakash, J., Yadav, Y., Srivastava, K., & Madhusudan, T. (2019). Psychosocial correlates of medication adherence in patients with depressive illness. Industrial Psychiatry Journal, 28(1), 135. https://doi.org/10.4103/ipj.ipj_78_19
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2018). Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders: A protocol for a systematic review. Systematic Reviews, 7(1), 1-5. https://doi.org/10.1186/s13643-018-0676-y
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2020). Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis. Systematic Reviews, 9(1), 1-18. https://doi.org/10.1186/s13643-020-1274-3
Soósová, M. S. (2016). Determinants of quality of life in the elderly. Central European Journal of Nursing and Midwifery, 7(3), 484-493. https://doi.org/10.15452/CEJNM.2016.07.0019
Tanguay Bernard, M. M., Luc, M., Carrier, J. D., Fournier, L., Duhoux, A., Côté, E., Lessard, O., Gibeault, C., Bocti, C., & Roberge, P. (2018). Patterns of benzodiazepines use in primary care adults with anxiety disorders. Heliyon, 4(7), e00688. https://doi.org/10.1016/j.heliyon.2018.e00688
Tavakoli-Fard, N., Mortazavi, S. A., Kuhpayehzadeh, J., & Nojomi, M. (2016). Quality of life, Work ability and other important indicators of women’s occupational health. International Journal of Occupational Medicine and Environmental Health, 29(1), 77-84. https://doi.org/10.13075/ijomeh.1896.00329
The WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551-558. https://doi.org/10.1017/s0033291798006667
Wand, T. (2019). Is it time to end our complicity with pharmacocentricity? International Journal of Mental Health Nursing, 28(1), 3-6. https://doi.org/10.1111/inm.12554
World Health Organization [WHO]. (2021). Primary health care. https://www.who.int/news-room/fact-sheets/detail/primary-health-care
Zheng, F., Duan, Y., Li, J., Lai, L., Zhong, Z., Hu, M., & Ding, S. (2019). Somatic symptoms and their association with anxiety and depression in Chinese patients with cardiac neurosis. Journal of International Medical Research, 47(10), 4920-4928. https://doi.org/10.1177/0300060519869711