Adesão medicamentosa em pacientes portadores de hipertensão arterial sistêmica: cardiologia de Augustinópolis, Tocantins

Abstract

Introduction: Cardiovascular diseases (CVDs) are the leading causes of death worldwide, and hypertension is one of the main risk factors. A problem in cardiology is the low adherence to drug treatment among patients with hypertension. It is known that many of these patients do not use their medications as prescribed by their physician. Low adherence to drug treatment is one of the reasons for inadequate blood pressure control. Thus, the objective of this study was to identify hypertensive patients treated at the outpatient clinic of a public hospital in the northern region of Tocantins (Hospital Regional de Augustinópolis) who do not adhere to drug treatment, discuss the reasons for low adherence, outline the socioeconomic profile, health habits, risk factors, gender, ethnicity and knowledge about the disease, and evaluate the association with low drug adherence. Methodology: This is a quantitative, descriptive, cross-sectional, observational study using field research. One of the methods used to measure the level of adherence was the Morisky-Green Test (MGT), a widely used and validated data collection instrument in Brazil; another instrument used was a questionnaire developed by the researcher to collect data such as age group, sex, education, number of pills prescribed per day, number of doses/day, socioeconomic aspects, duration of hypertension, and BMI (body mass index). Results: A total of 187 patients were treated at the cardiology outpatient clinic, of which 132 had hypertension. However, 120 patients participated in the study, since 11 patients chose not to participate and 1 patient was excluded because he was a minor. The majority were male (52.5%), over 60 years old (62.5%), illiterate (47.5%), who used more than 2 tablets per day for hypertension (36.1%), most had a family income between 1 and 2 minimum wages (49.2%) and had been using medication for hypertension for more than 10 years (40.3%). 52% of the patients were overweight (91% in adults and 29% in the elderly). The prevalence of patients without adequate adherence (low and moderate) was 60.8% and 15% when only patients with low adherence were evaluated. Forgetfulness was the main reason for these patients not taking their medication regularly. The study was evaluated taking into account two criteria; in criterion 1 (low adherence vs. moderate adherence/adherent), the association and the profile of the patients, based on Pearson's Chi-square test, it was found that there was a significant difference in only one variable studied (time of medication use). In criterion 2, the statistically significant variable was the number of pills taken per day (p = 0.011); these data were similar to those of other studies worldwide. Conclusions: Inadequate adherence to drug treatment among patients with hypertension is high in the cardiology outpatient clinic of Augustinópolis, TO, with the duration of medication use (criterion 1) and the number of pills taken per day (criterion 2) being statistically significant variables in adherence. Further investigations will be necessary, such as sample expansion and long-term follow-up, to better understand the reasons for the significant lack of adherence of patients with hypertension to drug treatment and to establish interventions to improve patient outcomes.