Full text
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| Author(s): |
Laura Bacelar de Araujo Lourenço
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2012-04-05 |
| Examining board members: |
Roberta Cunha Matheus Rodrigues;
Rosana Aparecida Spadoti Dantas;
Neusa Maria Costa Alexandre
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| Advisor: | Roberta Cunha Matheus Rodrigues |
| Abstract | |
This study was aimed at assessing the effect of the strategies Action Planning and Coping Planning, of the drug therapy adherence and health-related quality of life (HRQoL) among patients with coronary heart disease, as well as evaluating the relationship between drug adherence and HRQoL over a two-month follow-up. An experimental study was conducted with two phases of data collection. The sample comprised 115 patients randomized to intervention group (IG - n=59) and control group (CG - n=56). Measures of drug adherence (proportion of adherence and global assessment of adherence), factors related to the nonadherence (Brazilian version - Morisky Self-Reported Measure of Medication Adherence Scale), generic (Brazilian version - The Medical Study 36-Item Short Form Health Survey - SF-36) and specific HRQoL (Brazilian version - MacNew Heart Disease Health-related Quality of Life Questionnaire - MacNew) were obtained at baseline (T0) and after two months (T2) of follow-up. The intervention was applied to the GI at T0, strengthening face after one month of follow-up (T1). Descriptive analyses were conducted to characterize the sample according to sociodemographic, clinical, adherence and HRQoL. Student t test and chi-square tests were used to compare sociodemographic, clinical, compliance and HRQoL between patients of the IG and CG groups at T0. The Student t test was used to test differences in Morisky scale and HRQOL outcomes between IG and CG, and proportions tests were conducted to test differences in proportions of individuals with appropriate dose and adherent between IG and CG at T2. Linear regression analyses, both simple and logistic, were used to evaluate the effect of the intervention on measures of drug adherence and HRQoL. The Pearson correlation coefficient was used in order to test the relationship between adherence and HRQoL during follow-up. Positive changes in the drug adherence behavior were observed in IG patients, when considering the global assessment of adherence. The intervention explained 5% of the variability of the proportion of adherence after adjusting for other variables. IG patients were 5.3 times more likely to adhere to drug treatment. Higher significantly HRQoL scores were found in IG compared to CG, at T2, for all domains of the MacNew (p <0.05 - paired Student's t test) and for the domains Physical Function (p<0.001 - Test paired Student's t test) and Role Emotional (p<0.05 - Test paired Student's t test) of the SF-36, compared to baseline. Nevertheless, linear regression analysis evidenced that the intervention did not explain the variability of the generic and specific measures of HRQoL. Significant small-moderate magnitude correlations were observed between the measures of the proportion of adherence and Morisky scale and between the measures of the proportion of adherence and the specific measure of HRQoL in IG after two months of follow-up (T2). It is recommended that further experimental studies with longer follow-up period be developed in order to ratify the effect of the combination of planning strategies in drug adherence, as well as to elucidate the relationship between drug adherence and HRQoL (AU) | |
| FAPESP's process: | 09/12783-4 - Quality of life and drug adherence of patients with coronary disease |
| Grantee: | Laura Bacelar de Araujo Lourenço |
| Support Opportunities: | Scholarships in Brazil - Master |