Adesão Ao Tratamento Anti-Hipertensivo Em Idosos Com Comprometimento Cognitivo: Revisão Sistemática

Luz, Alyne Leal de Alencar; Griep, Rosane Härter; Landim, Maurício Batista Paes; Alencar, Delmo de Carvalho; Macedo, Juliana Bezerra; Leal, Antonia Lucimary de Sousa

doi:10.5380/ce.v26i0.70402

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…Conforme dados obtidos de prontuário, também foram descritas a baixa acuidade visual (34,7%) e défi cit cognitivo (28,6%), podendo este último afetar negativamente a execução de atividades diárias, além de comprometer o processo de aprendizagem e causar esquecimentos (23), o que difi culta a assimilação das orientações prestadas pelos profi ssionais de saúde. Nestes casos, o suporte de familiares ou cuidadores se torna fundamental para o sucesso do tratamento, e quando indisponível em alguns casos, foi discutido com a equipe médica a possibilidade de encaminhamento do caso para a assistência social para a tratativa do problema.…”

Section: Resultsunclassified

Cuidado Farmacêutico a Pacientes Idosos Em Um Hospital De Grande Porte

Tanaka

Viana

Rocha

2022

Infarma

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O processo de envelhecimento está frequentemente associado à presença de múltiplas comorbidades e, consequentemente, à polifarmácia. Além disso, indivíduos idosos normalmente apresentam condições que demandam atenção especial nos cuidados à saúde, como comprometimento cognitivo, alterações fisiológicas e necessidade de suporte social, o que pode comprometer a autonomia destes indivíduos. O presente estudo teve por objetivo descrever o perfil clínico e sociodemográfico dos pacientes idosos acompanhados em um hospital de grande porte, localizado no município de São Paulo, SP, Brasil, quais as atividades clínico-assistenciais desenvolvidas no cuidado farmacêutico e pontos a serem melhorados. Trata-se de um estudo transversal, com coleta de dados em sistemas informatizados institucionais, de forma retrospectiva, no período de junho de 2018 a julho de 2021. Foram consideradas as variáveis sociodemográficas e assistenciais relacionadas ao acompanhamento farmacoterapêutico, onde a média de idade da população do estudo foi de 79 ±7 anos, baixa escolaridade e prevalência do gênero feminino. Foram observadas em média 5 ±2,5 comorbidades por paciente, o uso de 13 ±3,4 medicamentos e tempo de acompanhamento farmacoterapêutico médio de 12 ±10,8 meses, com predominância de 10 meses, período em que se desenvolveram diversas estratégias para a melhora da adesão ao tratamento. Este estudo possibilitou identificar que os principais pontos de intervenção farmacêutica foram relacionados à adesão ao tratamento, o baixo grau de entendimento sobre a farmacoterapia, duplicidade de prescrições, armazenamento inadequado de medicamentos, entre outros, para os quais foram desenvolvidas estratégias visando a resolução destes problemas, com destaque para ações de educação em saúde, elaboração de tabela de orientação e solicitação de automonitoramento residencial glicêmico e pressórico. Ademais, as limitações encontradas devido à falta de registros das intervenções com a equipe médica e informações sobre perda de seguimento, indicam a oportunidade de melhoria dos registros farmacêuticos.

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Section: Resultsunclassified

Cuidado Farmacêutico a Pacientes Idosos Em Um Hospital De Grande Porte

Tanaka

Viana

Rocha

2022

Infarma

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“…ineffective relationship between patient and professional; among others. The same evidences also point out that cognitive deficit, low education and degree of dependence are relevant risk factors and that are strongly associated with non-adherence to antihypertensive treatment, especially medication in the elderly Luz et al (2021).…”

Section: Global Health Trends and Perspectives In Health Sciencesmentioning

confidence: 87%

Hypertension in the elderly: Determining factors for non-adherence to drug therapy, potentiated by the Covid-19 pandemic

Ramos¹,

Silva²,

Lima³

et al. 2023

Global Health Trends and Perspectives in Health Sciences

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Objective: To discuss and highlight in the literature the determining factors of non-adherence of elderly patients with RAS to drug therapy, potentiated by the COVID pandemic 19. Material and method: This is a literature review that aims at the analysis and synthesis of the determining factors for the non-adhering of the elderly with hypertension to drug treatment. We analyzed the publications produced between 2017 and 2022, with full texts and available in the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS) and Google Scholar, in addition to the manual of the 7th Brazilian Guidelines on Arterial Hypertension and the World Health Organization (WHO). Results: The search in the databases resulted in the identification of 1,203 articles. After the final reading, 32 articles were selected that contemplated the objectives discussed in the development of this work. Final considerations: It was found that many factors interfere with the non-adherence of the elderly to drug therapy, factors that are linked to the elderly and the health system, as the patient presents difficulties in following the proposed therapeutic scheme, either due to its complexity, forgetfulness, adverse effect of the drug and its belief in alternative empirical drugs.

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“…Cognitive impairment was also associated with low adherence, even in patients without dementia [27]. Similarly, Luz et al conducted a systematic review that confirmed the association between cognitive impairment and low adherence, but the mechanisms underlying it were still not clear [79].…”

Section: Table 2: Determinants Of Adherence To Antihypertensive Therapymentioning

confidence: 99%

Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review

Ferreira,

Simoes,

Velho

2024

Cureus

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Hypertension is a globally prevalent condition, and low adherence to antihypertensive therapy is considered one of the main causes of poor blood pressure (BP) control. Non-adherence to antihypertensive treatment is a complex issue that can arise from various factors; however, gaining an understanding of this provides key targets for intervention strategies. This study aimed to provide an overview of the current status and recent developments regarding our understanding of the determinants of patients' adherence to antihypertensives. A systematic review was performed using the electronic databases MEDLINE/PubMed, Web of Science, Scientific Electronic Library Online (SciELO), and "Índex das Revistas Médicas Portuguesas", which included studies published between 2017 and 2021 following the PICOS model: (P) Adult patients with the diagnosis of primary hypertension, using at least one antihypertensive agent; (I) all interventions on both pharmacological and non-pharmacological level; (C) patient's adherence against their non-adherence; (O) changes in adherence to the therapeutic plan; and (S) any study design (except review articles) written in English, French, Spanish or Portuguese.Articles were reviewed by two researchers and their quality was assessed. Subsequently, determinants were classified according to their consistent or inconsistent association with adherence or non-adherence. Only 45 of the 635 reports identified met the inclusion criteria. Adherence was consistently associated with patient satisfaction with communication, patient-provider relationship, their treatment, and use of eHealth and mHealth strategies; a patient's mental and physical health, including depression, cognitive impairment, frailty, and disability, previous hospitalization, occurrence of vital events; drug treatment type and appearance; and unwillingness due to health literacy, self-efficacy, and both implicit and explicit attitudes towards treatment. There were discrepancies regarding the association of other factors to adherence, but these inconsistent factors should also be taken into account. In conclusion, the barriers to adherence are varied and often interconnected between socioeconomic, patient, therapy, condition, and healthcare system levels. Healthcare teams should invest in studying patients' non-adherence motives and tailoring interventions to individual levels, by using a multifaceted approach to assess adherence. Further research is needed to analyze the impact of implicit attitudes, the use of new technological approaches, and the influence of factors that are inconsistently associated with non-adherence, to understand their potential in implementing adherence strategies.

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Adesão Ao Tratamento Anti-Hipertensivo Em Idosos Com Comprometimento Cognitivo: Revisão Sistemática

Cited by 6 publications

References 29 publications

Cuidado Farmacêutico a Pacientes Idosos Em Um Hospital De Grande Porte

Cuidado Farmacêutico a Pacientes Idosos Em Um Hospital De Grande Porte

Hypertension in the elderly: Determining factors for non-adherence to drug therapy, potentiated by the Covid-19 pandemic

Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review

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