Evaluation of adherence to drug therapy in elderly hypertensive patients before and after the development and the use of an Electronic System of Personal and Controlled Use of Medication (SUPERMED)

Author(s)

Liliana Batista Vieira

• Document type: Doctoral Thesis
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
• Defense date: 2013-12-20

Examining board members

Silvia Helena De Bortoli Cassiani; Osvaldo de Freitas; Maria Suely Nogueira; Leonardo Régis Leira Pereira; Ana Elisa Bauer de Camargo Silva

• Advisor: Silvia Helena De Bortoli Cassiani

Abstract

Considering that the arterial systemic hypertension has a high prevalence, low control taxes and that the risk to develop the disease increases with the aging, the objective of this study was to evaluate the adherence to the drug therapy in a group of elderly patients who have hypertension and are taken care of in a Basic Health Care Unit, in the country of São Paulo state, before and after the development and the utilization of an Electronic System of Personal and Controlled Use of Medication (SUPERMED). The study was almost experimental, prospective and comparative. 32 hypertensive elders were monitored, who used continually at least four different medications, in different periods: \"before the use of SUPERMED\", at \"the day that they started using it\" and \"after the use of SUPERMED\". To monitor the elderlies, the following SUPERMED resources were used: organizing medications boxes, identified with the suitable use time, the single dose pill packs and an alarm clock. The adherence was evaluated by the Morisky and Green Test, applied before and after the use of SUPERMED. During all the monitoring, the arterial pressure and the postprandial glycemia were controlled from the body mass index and the waist circumference. The project was approved by the Ethics Committee in Research from the College of Nursing from the University of São Paulo at Ribeirão Preto and approval from the research participants was asked, followed by the signing of the Statement of Consent. All the analysis was conducted with a statistics software application and the Microsoft Excel program. The elders´ average age in the study was 71.4 years old (DP 5.6); the female gender had the prevalence (65.6%); 18.8% were illiterate; the diagnosis average of hypertension was 19.4% (DP 10.1) years and the average of drugs used per elder was 8. Besides the hypertension, 75% of the elders showed diabetes mellitus, dyslipidemia rate was 75% and 59.4% were obese. After the use of SUPERMED, the systolic arterial pressure values\' average decreased in 21.6 mmHg (p<0.0001) and the diastolic arterial pressure in 4.7 mmHg (p<0.0001). The Morisky and Green Test results showed a low adherence before SUPERMED was implanted, where 81.2% of the elders were considered \"less adherent\". After it was implanted, 96.9% were considered \"more adherent\" (p<0.01). The use of SUPERMED improved the medication adherence and decreased the arterial pressure values, providing the elders with safety and satisfaction about the organization and the proper use of their medications (AU)

• FAPESP's process: 10/03448-4 - Assessment of medication adherence of patients of a Basic Health Unit of the State of Sao Paulo before and after the use of a Custom Kit Pharmaco (KFP)
• Grantee: Liliana Batista Vieira
• Support Opportunities: Scholarships in Brazil - Doctorate