Factors associated with therapeutic adherence in diabetics in two Peruvians hospitals
Keywords:
therapeutic adherence, diabetes mellitus, chronic disease, life style.Abstract
Introduction: Different studies show poor therapeutic adherence in diabetic patients, so it is important to identify the factors associated with this one.Objective: To determine the frequency of and factors associated with therapeutic adherence in type 2 diabetics treated at two hospitals in Lambayeque, Peru-2020.
Methods: Analytical cross-sectional study in 119 patients with type 2 diabetes mellitus with microangiopathy and/or neuropathy, who were applied the Morisky-Green questionnaire validated in Spanish. An association was explored between therapeutic adherence and time of illness, presence of complications, type of antidiabetic, polypharmacy, comorbidity, sex, age, and degree of education.
Results: Of 119 participants, 61,3 % were women, 56,3 % were aged 65 years or older, 43,7 % had neuropathies, and 33,6 % of patients were taking oral antidiabetics and insulin.Only 26,9 % of the patients presented therapeutic adherence. In the simple regression analysis, it was found that the factors associated with a greater frequency of therapeutic adherence were male sex (Prevalence ratio=2,04) and having a higher level of education (Prevalence ratio=2,24). In the multiple regression analysis, male patients had an 85 % greater frequency of therapeutic adherence than female patients (Prevalence ratio=1,85). Therapeutic adherence in patients with higher educational levels was 106 % higher than in participants with no higher educational level (Prevalence ratio=2,06).
Conclusions: The patients studied show low therapeutic adherence. The factors associated with greater therapeutic adherence are male sex and higher educational level.
Downloads
References
2. World Health Organization. World Diabetes Report.World Health Organization.2016 [acceso: 31/03/2019]. Disponible en: https://www.who.int/publications/i/item/9789241565257
3. International Diabetes Federation. Atlas de la diabetes de la FID. International Diabetes Federation. 2015[acceso: 31/03/2019]. Disponible en: https://www.fundaciondiabetes.org/upload/publicaciones_ficheros/95/IDF-_Atlas_2015_SP_WEB_oct2016.pdf
4. Aguilar Sánchez M, Maldonado Gonzales YD, HuzcoRutti CN. Prevalencia de factores asociados y complicaciones crónicas en pacientes adultos mayores con Diabetes Mellitus tipo 2 en el Centro de Atención Primaria nivel III EsSalud - El Agustino. Revista Científica De Ciencias De La Salud. 2018 [acceso 31/03/2019]; 11(1):31-43. Disponible en: https://revistas.upeu.edu.pe/index.php/rc_salud/article/view/1057/pdf
5.Machaca M, Yovana L. Nivel de conocimiento de complicaciones en diabetes mellitus tipo 2 y adherencia al tratamiento en pacientes de consultorio de endocrinología del Hospital Nacional Arzobispo Loayza (junio 2018-febrero 2019). [Tesis para optar por el Título Profesional de Médico Cirujano]. Perú:Universidad Nacional Mayor de San Marcos;2019. [acceso: 31/03/2019]. Disponible en: https://cybertesis.unmsm.edu.pe/handle/20.500.12672/10326
6. Barra S. Adherencia al tratamiento farmacológico oral de personas con diabetes mellitus en 7 localidades de la costa de Perú.[Tesis para optar al grado de Maestro en diabetes y obesidad con mención en manejo nutricional]. Perú: Universidad Peruana Cayetano Heredia;2018. [acceso: 31/03/2019]. Disponible en: https://repositorio.upch.edu.pe/bitstream/handle/upch/3737/A-dherencia_BarraMalig_Solange.pdf?sequence=1&isAllowed=y
7. Guamuro JEG, Vásquez GF, Barrera HYG, Cruz LAG, Caceres VAS. Nivel de Adherencia al Tratamiento Farmacológico y Dietético en Pacientes del Programa de Diabetes del Policlínico Chiclayo Oeste - Essalud en diciembre del 2015. Revista Experiencia en Medicina del Hospital Regional Lambayeque: REM. 2016
[acceso: 13/05/2019];2(1):23-8. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=5971579
8. Villalobos Rios MDC, Villalobos Carlos PD, Leguía-Cerna J. La educación como piedra angular de la adherencia terapéutica en pacientes con Diabetes Mellitus tipo 2. Revista Médica Herediana. 2017[acceso: 31/03/2019]; 28(3):218-9. Disponible en: https://doi.org/10.20453/rmh.v28i3.3194
9. Val Jiménez A, Amorós Ballestero G, Martínez Visa P, Fernández Ferré ML, León Sanromà M. Descriptive study of patient compliance in pharmacologic antihypertensive treatment and validation of the Morisky and Green test. Aten Primaria. 1992
[acceso: 30/10/2020]; 10(5):767-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov/1472599/
10.Mediavilla JJ. Factores asociados con la adherencia a la medicación en las personas con diabetes tipo 2. DiabetMed. 2015[acceso: 21/04/2019]; 32(6):725-37. Disponible en: https://www.redgdps.org/gestor/upload/file/UPDATE%202015/Update-%20en%20diabetes%206-2-2-2015%20.pdf
11. Pfizer. La adherencia al tratamiento: cumplimiento y constancia para mejorar la calidad de vida. Madrid: Pfizer; 2009. [acceso: 08/12/2020]. Disponible en: https://www.pfizer.es/docs/pdf/asociaciones_pacientes/2009/FORO-pfizer_2009.pdf
12. Figueroa C. Factores asociados con la no Adherencia al tratamiento de pacientes diabéticos en un programa de control de Riesgo Cardiovascular. [Tesis Magíster en Epidemiología]. Colombia: Universidad Industrial de Santander;2011.[acceso: 21/04/2019]. Disponible en: https://tangara.uis.edu.co/biblioweb/tesis/2011/142042.pdf
13. Kirkman MS, Rowan-Martin MT, Levin R, Fonseca VA, Schmittdiel JA, Herman WH, et al. Determinants of adherence to diabetes medications: findings from a large pharmacy claims database. Diabetes Care. 2015[acceso: 10/10/2020];38(4):604-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25573883/
14. García I, Rodríguez M. Vista de Situación en que viven y adhesión al tratamiento en mujeres y hombres de San Luis Potosí con VIH/SIDA. Acta Universitaria. 2014
[acceso: 08/10/2020]; 24(4):12. Disponible en: https://www.actauniversitaria.ugto.mx/index.php/acta/article/view/-515/pdf_19
15. Reyes E, Trejo R, Arguijo S, Jiménez A, Castillo A, Hernández A, et al. Adherencia terapéutica: conceptos, determinantes y nuevas estrategias. Revmedhondur. 2016[acceso: 08/10/2020]; 84:8. Disponible en: https://www.bvs.hn/RMH/pdf/2016/pdf/Vol84-3-4-2016-14.pdf
16. Mattos G, Ochoa A. Adherencia al tratamiento en pacientes con diabetes mellitus tipo 2 en el hospital de bosa, Bogotá entre agosto y octubre de 2015. [Tesis de Médico]. Colombia: Universidad Ciencias Aplicadas y Ambientales;2015[acceso: 21/04/2019]. Disponible en: https://repository.udca.edu.co/bitstream/11158/577/3/Mattos%20Mart-%C3%ADnez.pdf
17. Ramos Y, Morejón R, Gómez M, Reina ME, Rangel C, Cabrera Y. TherapeuticAdherence in Patientswith Diabetes Mellitus Type 2. Finlay. 2017[acceso: 31/03/2019];7(2):[aprox. 9 p.]. Disponible en: https://www.revfinlay.sld.cu/index.php/finlay/article/view/474
18.Navarro G, Buitrago E, Pallares W, Niño F. Factores que intervienen en la falta de adherencia al tratamiento antidiabético. Huem 2016-1. Revista Científica del Departamento de Medicina. 2017[acceso: 08/10/2020]; 4(1):73-80. Disponible en: https://revistas.unipamplona.edu.co/ojs_viceinves/index.php/INBIOM/-article/view/2419
19. Sagástegui S. Factores explicativos de la no adherencia al tratamiento antihipertensivo. [Tesis de Médico Cirujano]. Perú: Universidad Nacional de Trujillo;2019.[acceso: 19/10/2020]. Disponible en: https://dspace.unitru.edu.pe/bitstream/handle/UNITRU/15331/Sag%-c3%a1steguiS%c3%a1nchez_S.pdf?sequence=1&isAllowed=y
Published
How to Cite
Issue
Section
License
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.