Factors Associated to Adherence to Different Treatment Schemes With Meglumine Antimoniate in a Clinical Trial for Cutaneous Leishmaniasis

Abstract

The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA) in the treatment of cutaneous leishmaniasis (CL), in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule); we observed 82.1% (vial return), 86.0% (monitoring card), 66.7% (Morisky test) and 86.0% (modified Morisky test) adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

Favorable responses to treatment with 5 mg Sbv/kg/day meglumine antimoniate in patients with American tegumentary leishmaniasis acquired in different Brazilian regions

“…Between 2001 and 2013, only 4% of 777 patients treated at INI were lost to follow-up 10 . Another study found a significant association between greater adherence to treatment and the use of 5 mg Sb v /kg/day MA treatments 43 . Other authors reported that an intermittent schedule (longer than the standard schedule) was associated with a lower frequency of discontinuation of treatment and loss to follow-up 21 .…”

CpG ODN D35 improves the response to abbreviated low-dose pentavalent antimonial treatment in non-human primate model of cutaneous leishmaniasis

“…In several studies, treatment with Sb V accelerated healing of CL lesions when used at 10-30 mg/kg/day IV or IM for 20-30 days, but the success rate ranges between 25 and 90% depending on the population and the strain of Leishmania, and even at the higher doses there are relapses [3,7]. Importantly, this prolonged high-dose treatment regimen is associated with severe adverse effects including cardiotoxicity (prolonged QTc interval, premature beats, tachycardia, fibrillation), pancreatitis, liver and kidney toxicities, malaise, myalgia, and anorexia [8,9]. Lastly, there are growing reports in India, Iran, and Peru of emerging resistance to antimonials in the field [10][11][12][13][14].…”

Adherencia al tratamiento ortodóncico de pacientes adolescentes atendidos en una institución docente asistencial de Medellín. Estudio transversal

“…En la práctica del ortodoncista lo que más se observa empíricamente durante un tratamiento de ortodoncia es que el éxito o fracaso de éste se puede asociar a la sumatoria de factores descritos anteriormente (16), con una proporción de deserción del tratamiento hasta del 21.4 % (4). Esta variabilidad hace que los pacientes presenten inconvenientes en mantener su tratamiento de manera apropiada; vale decir, cumplimiento de todas y cada una de las recomendaciones del clínico (15,(17)(18)(19).…”

“…Autores como Haynes y Sackett (1980) y Morinsky, Green y Levine (1986) propusieron diferentes cuestionarios, los cuales se utilizan con mayor frecuencia en la e-ISSN 2357-4607 / Vol.15, n°. 28 / enero-junio 2019 / Bogotá D.C., Colombia Universidad Cooperativa de Colombia Juliana Cano Restrepo, Cecilia María Martínez Delgado práctica clínica médica debido a su alta especificidad, sencillez y brevedad (23)(24)(25)18).…”

“…A pesar del gran interés por el tema, en la actualidad hay varias formas de medir la adherencia, por lo que se pueden hacer de manera individual o combinada con el fin de corregir las insuficiencias que los instrumentos puedan poseer (18): 1) Los métodos objetivos directos se basan en la determinación del fármaco, de sus metabolitos o de sustancias trazadoras en algún fluido biológico, frecuentemente sangre u orina.…”