Pacientes hipertensos não controlados atendidos em unidade de pronto atendimento: crenças e adesão ao tratamento medicamentoso.

Abstract

Systemic arterial hypertension is a chronic non-transmissible disease considered a major public health problem, associated with fatal and non-fatal cardiovascular events that generate high costs with hospital admissions to the public health system. Reducing the incidence and occurrence of associated cardiovascular complications requires the individual to have adequate treatment throughout life, as well as their therapeutic adherence. Objectives: To characterize the uncontrolled hypertensive patients attended at the prompt care unit, to verify adherence to drug treatment and to determine the beliefs emitted by uncontrolled hypertensive patients related to adherence to prescribed drug therapy. Methodology: This is a descriptive, cross - sectional study with a quantitative approach. The study was attended by 122 hypertensive subjects with PA≥140x90mmHg who were attended at the screening room of the Emergency Room 24h of Campina Grande, PB; During the data collection period (June to July 2017). The sample was non-probabilistic, and selected for convenience. Measurements of the brachial circumference and then of the blood pressure of each subject were performed, and the one with PA≥140x90 mmHg was invited to participate in the study. Participants were interviewed using the socio-demographic identification forms, the Morisky Medication Adherence Scale (MMAS-8) and the treatment beliefs form for hypertension, according to the constructs of the Theory of Rational Action (TAR ). The data collected were analyzed from the Statistical Package for the Social Sciences (SSPS) version 21. Results: A profile of hypertensive patients with uncontrolled BP was observed, a majority of the elderly 61.25 (14.48), female 80 (65.6%), white 72 (59%), married 60 (49.2%), retired 55 (45.1%), low income 1.1 (0.92), schooling 6.35 (5.41) and non adherence to pharmacological treatment for arterial hypertension by 69 (56.6%) subjects. The behavioral beliefs evaluated in relation to the advantage in adhering to the most reported treatment was controlling the pressure 38 (31.1%) and most described none 82 (67.2%) as a disadvantage. In the normative beliefs, as the most influential positive social referent, the children 59 (48.8%) were obtained, and as a negative reference 105 (86.1%). Conclusions: It is necessary to know the behavioral and normative beliefs of hypertensive patients in order to better understand the levels of adherence to pharmacological treatment. This knowledge provides the implementation of strategies based on these beliefs so that there is a better behavioral intention to adhere to the drug treatment, thus modifying the behavior of these subjects before taking antihypertensive drugs.