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Nonadherence of patients to treatment in diabetes: challenge for completeness in primary care

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Author(s):
Clarissa Cordeiro Alves Arrelias
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Maria Lucia Zanetti; Heloisa Turcatto Gimenes Faria; Carla Regina de Souza Teixeira
Advisor: Maria Lucia Zanetti
Abstract

Descriptive transversal study aimed to characterize the patient with diabetes mellitus that had no treatment adherence according to socio-demographic variables, clinical and therapeutic, and relate to nonadherence and the variables sex, age, years of study, time of diagnosis, glycated hemoglobin, total cholesterol, triglycerides, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. The data were from a base sectional study conducted in 2010 in 17 family health units of the municipality of Passos, Minas Gerais. The sample consisted of 417 patients with type 2 diabetes mellitus who have nonadherence to treatment. For analysis, we used descriptive statistics and the Fisher exact Test. For the quantification of logistic regression was employed, with the calculation of the Odds ratio. The results showed that there was a predominance of women, average of 62.4 years, 2.6 years of study and 4.2 minimum wages. Most had diagnostic time less than ten years, overweight, abdominal obesity, high systolic blood pressure values. The most reported complications and comorbidities were hypertension. The complication and comorbidity more reported was hypertension and retinopathy, respectively. The most commonly used oral antidiabetics were the biguanidas and the sulfonilureias. The consumption of saturated fat, dietary fiber and fractionation of daily meals were not according to the recommended parameters. The level of physical activity was considered moderately active and very active for most patients. By adopting the significance level of 5%, in which p values less than 0.05 were considered significant, not statistically significant difference was found between nonadherence and the variables studied. However, those with study time equal to or less than the eight years had a higher chance of not joining the food plan; the glycated hemoglobin values greater than 6.5% had a higher chance of not adhering to drug treatment, and the total cholesterol values equal to or greater than 200 mg/dl, the eating plan. It is expected that the results contribute to the situational diagnosis of the patients with diabetes of 17 family health units investigated and to the search for innovative strategies in confronting the weaknesses in relation to nonadherence to the three pillars of diabetes treatment. This evaluation can also be a valuable tool for measuring the impact of interventions implemented. (AU)

FAPESP's process: 11/04305-5 - Non-adherence to treatment user: a challenge for comprehensive care in diabetes
Grantee:Clarissa Cordeiro Alves Arrelias
Support Opportunities: Scholarships in Brazil - Master