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      Adherencia al tratamiento farmacológico en pacientes hipertensos atendidos en un hospital general Translated title: Adherence to pharmacotherapy in hypertensive outpatients attended at general hospital

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          Abstract

          La falta de adherencia es un hecho recurrente y un problema global, que impide que la morbi-mortalidad asociada a enfermedades crónicas que pueda ser evitada. Objetivo: Determinar la adherencia al tratamiento farmacológico en pacientes hipertensos atendidos en un hospital general. Material y Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, transversal en el que se entrevistó a pacientes atendidos en consultorios externos del Hospital Nacional Cayetano Heredia utilizando el Test de Morisky-Green para determinar su adherencia al tratamiento farmacológico y se determinó el nivel de presión arterial. Resultados: 69,9% eran mujeres, 77,7% tenía un tiempo de enfermedad mayor de tres años. El 52,4% tenían educación primaria, 68% eran casados, 62,1% tenían su presión arterial controlada. La adherencia al tratamiento farmacológico fue 37,9%. Se halló asociación entre adherencia con el estado civil viudo y entre adherencia y presión arterial controlada (p<0,05). Conclusión: La adherencia al tratamiento farmacológico fue 37,9%. (Rev Med Hered 2010;21:197-201).

          Translated abstract

          Lack of adherence is a common and global problem that avoid in patients with chronic diseases obtain benefit from treatments that can prevent morbidity and mortality. Objective: To determine adherence to drug treatment in chronic hypertensive patients treated in a general hospital. Material and Methods: An observational, descriptive, prospective, cross-sectional study was performed in patients attending to the outpatient clinic of the Hospital Nacional Cayetano Heredia using the Morisky-Green Test to determine their adherence to drug treatment and determine the blood pressure control. Results: 69.9% were women, 77.7% had disease duration longer than three years. 52.4% had primary education level, 68% were married, 62.1% had their blood pressure under control. Adherence to drug treatment was 37.9%. Association between adherence with the widower status and blood pressure control (p <0.05) were found. Conclusion: Adherence to drug treatment was 37.9%. (Rev Med Hered 2010;21:197-201). )

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          Most cited references30

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          Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence

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            The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure.

            Racial and ethnic minority populations are growing segments of our society. The prevalence of hypertension in these populations differs across groups, and control rates are not as good as in the general population. Clinicians should be aware of these management challenges, taking social and cultural factors into account. Guidelines are provided for management of children and women with hypertension. In older persons, diuretics are preferred and long-acting dihydropyridine calcium antagonists may be considered. Specific therapy for patients with LVH, coronary artery disease, and heart failure are outlined. Patients with renal insufficiency with greater than 1 g/d of proteinuria should be treated to a therapy blood pressure goal of 125/75 mm Hg; those with less proteinuria should be treated to a blood pressure goal of 130/85 mm Hg. ACE inhibitors have additional renoprotective effects over other antihypertensive agents. Patients with diabetes should be treated to a therapy blood pressure goal of below 130/85 mm Hg. Hypertension may coexist with various other conditions and may be induced by various pressor agents.
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              Helping patients with type 2 diabetes mellitus make treatment decisions: statin choice randomized trial.

              Poor quality of information transfer about the benefits and risks of statin drug use may result in patients not making informed decisions that they can act on in a timely fashion. The effect of a decision aid about statin drugs on treatment decision making in 98 patients with diabetes was determined in a cluster randomized trial of decision aid vs control pamphlet, with concealed allocation, blinding of participants to study goals, and adherence to the intention-to-treat principle. Twenty-one endocrinologists conducted specialty outpatient metabolic consultations. Patients in the intervention group received Statin Choice, a tailored decision aid that presents the estimated 10-year cardiovascular risk, the absolute risk reduction with use of statin drugs, and the disadvantages of using statin drugs. Patients in the control group received the institution's pamphlet about cholesterol management. We measured acceptability, knowledge about options and cardiovascular risk, and decisional conflict immediately after the visit, and adherence to pill taking was measured 3 months later. Patients favored using the decision aid (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.2-6.9); patients who received the decision aid (n = 52) knew more (difference, 2.4 of 9 points; 95% CI, 1.5-3.3), had better estimated cardiovascular risk (OR, 22.4; 95% CI, 5.9-85.6) and potential absolute risk reduction with statin drugs (OR, 6.7; 95% CI, 2.2-19.7), and had less decisional conflict (difference, -10.6; 95% CI, -15.4 to -5.9 on a 100-point scale) than did patients in the control group (n = 46). Of 33 patients in the intervention group taking statin drugs at 3 months, 2 reported missing 1 dose or more in the last week compared with 6 of 29 patients in the control group taking statin drugs (OR, 3.4; 95% CI, 1.5-7.5). A decision aid enhanced decision making about statin drugs and may have favorably affected drug adherence.
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                Author and article information

                Journal
                rmh
                Revista Medica Herediana
                Rev Med Hered
                Universidad Peruana Cayetano Heredia. Facultad de Medicina "Alberto Hurtado" (Lima, , Peru )
                1018-130X
                1729-214X
                October 2010
                : 21
                : 4
                : 197-201
                Affiliations
                [02] Lima orgnameUniversidad Peruana Cayetano Heredia orgdiv1Facultad de Medicina Alberto Hurtado orgdiv2Profesor Asociado Perú
                [01] Lima orgnameUniversidad Peruana Cayetano Heredia orgdiv1Facultad de Medicina Alberto Hurtado orgdiv2Egresado Perú
                Article
                S1018-130X2010000400005 S1018-130X(10)02100405
                10.20453/rmh.v21i4.1114
                89c2d709-5d15-45bc-9f7b-aaeebddb5784

                http://creativecommons.org/licenses/by/4.0/

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 5
                Product

                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos originales

                Adherencia,Morisky-Green,hipertensión,Adherence,hypertension

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