Instrumentos para mensurar a adesão à farmacoterapia – uma revisão integrativa.

Abstract

Adherence to pharmacotherapy is directly related to the patient's behavior according to the guidelines of health professionals. However, non-compliance with the prescribed therapy has been seen, representing an example of a Drug-Related Problem (PRM). Instruments to assess adherence to drug treatment assist the pharmaceutical professional in resolving PRMs, in order to improve and ensure effective and safe pharmacotherapy. The objective of this work was to analyze instruments for assessing adherence for the effectiveness of pharmacological therapy, including the factors influencing non-adherence and the pharmaceutical interventions carried out to change this conduct. For this, a literature review was carried out in the electronic databases PubMed, Google Scholar, SciELO, LILACS and CAPES journals, using publications between 2005 and 2020 and the following terms (keywords and delimiters) and combinations thereof: 1) Therapeutic Adherence; 2) Pharmacotherapy; 3) Adherence Assessment Instrument and 4) Pharmaceutical Care to answer the guiding questions. The sample consisted of 23 studies that showed the existence of ten indirect instruments for the assessment of therapeutic adherence, the Morisky and Green Test being the most used, present in 10 of the 23 studies (43%), either in isolation (7) be associated with another methodology (3), followed by the Adhesion Measurement Test (4), due to the low cost and easy applicability, but without consensus to define a gold standard. Elements such as: gender, race / ethnicity, socioeconomic factors, cultural aspects, beliefs about treatment, illness and health professionals and services, make it difficult for patients to comply with drug therapy. The importance of the pharmaceutical professional in participating in the health team was related to interventions such as therapeutic listening, pharmacotherapeutic monitoring and health education, according to the needs of each individual. Studies like this help to understand the factors that prevent patients from complying with the dosing regimen and the planning of interventions that improve clinical outcomes by reducing the negative results associated with medications (MRIs). Still, they awaken and optimize ideas for the development of new valid and reliable instruments for the identification of possible flaws in the pharmacotherapeutic treatment.