Adesão à terapêutica na asma

Abstract

Background: Adherence to therapy in bronchial asthma is essential for the control of the disease. Several studies show that non -adherence seems to be the result of different factors and barriers associated with the patient, but also with the prescriber. The most important are the psychological, economic and social aspects. In clinical practice, there are few resources that allow the physician to objectify the degree of compliance of his prescription. The aim of this study was to analyze the degree of adherence to therapy in asthmatic patients followed in a Hospital Immunoallergology Department. Methods: The clinical trials of 63 asthmatic patients followed at the Immunoallergology Department from January to December of 2016 (T0) and from January to December of 2017 (T1) were retrospectively studied. The number of packs prescribed to the patients by the attending physician and the number of packs actually purchased in pharmacies were analyzed in T0 and T1 by means of Electronic Medicines Prescriptions (PEM) records for the following drugs: bronchodilators (BD), inhaled corticosteroids isolated or in combination with bronchodilators (OUT), oral antihistamines (AH), leukotriene antagonists (LCRA), nasal corticosteroids (CN) and oral corticosteroids (CO). The following demographic and clinical variables were analyzed: age, sex, clinical diagnosis, atopy, allergen sensitization and specif ic immunotherapy treatment (ITE). Results: We found a compliance of 64.76% to the prescription. The drugs which the patients most adhere were oral corticosteroids (73%), followed by leukotriene antagonists and antihistamines (70%). When analysing associations between variables, it was observed that patients who were not under ITE had greater adhesion to the inhalers (BD and CI) (p <0.05). The asthmatic group had a positive association with adherence to the LCRA (p <0.05) and in the analysis by age, we found that the infant population had a positive association with adherence to AH (p <0.05). Conclusions: To improve adherence to therapy in asthma, it is important to address and know patient’s compliance. The study of each patient’s adherence based on computerized drug prescription and retrieval systems in pharmacies allows prescribing physicians to introduce this variable into the analysis of asthma control.