Adesão ao tratamento farmacológico de pacientes com hepatite C, atendidos em hospital de referência do estado de Santa Catarina
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Arquivos
Data
2015
Tipo de documento
Dissertação
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
Barcelos, Thaís Moreira
Orientador
Trevisol, Daisson José
Coorientador
Resumo
A hepatite C foi descoberta em 1989 e até o presente momento, não há diretrizes formais para a avaliação da adesão ao tratamento do HCV. Estudos sobre as taxas de adesão aos antirretrovirais nos paciente HIV levaram ao desenvolvimento de muitas intervenções eficazes nos pacientes no intuito de melhorar a adesão ao tratamento. Objetivo: Verificar a adesão ao tratamento da hepatite C e em pacientes atendidos no ambulatório de infectologia do Hospital Nereu Ramos em Florianópolis (SC). Métodos: Estudo transversal, com 123 pacientes em tratamento farmacológico para hepatite C, sendo incluídos todos os pacientes em tratamento no período do estudo. Para avaliação da adesão ao tratamento medicamentoso da Hepatite C, foi aplicado o questionário Morisky-Green. As variáveis qualitativas foram apresentadas em valores absolutos e relativos. As quantitativas em valores de tendência central e de dispersão. Para verificar a associação entre as variáveis qualitativas serão utilizados o testes de Qui-quadrado de Pearson e o teste t de Student. A Razão de prevalência foi calculada utilizando a Regressão de Poisson modificada. Resultados: Foram avaliados 123 pacientes em tratamento para hepatite C. Do total 89 (72,4%) eram do sexo masculino, com média de idade de 51,7 (DP=9,4) anos. Com relação ao questionário Morisky-Green verificou-se que 96 (78%) dos pacientes não aderiram ao tratamento. Os fatores que mais interferiram na adesão foram o esquecimento de tomar a medicação, 50 (40,6%) e o fato de se sentirem incomodados ao seguir corretamente o tratamento, 66(53,65%). Dos 34 pacientes que realizaram o teste de resposta virológica sustentada para avaliar a carga viral, 30 apresentaram resposta virológica sustentada, ou seja, carga viral indetectável, enquanto que quatro pacientes permaneceram com carga viral detectável. Conclusão: Conclui-se que a adesão ao tratamento de Hepatite C é baixa, necessitando de acompanhamento de equipe multidisciplinar para melhorar o tratamento. Apesar disto, dos pacientes que realizam o tratamento completo, a maioria apresenta carga viral indetectável após seis meses de tratamento.
Although hepatitis C virus (HCV) was discovered in 1989, no formal guidelines for the evaluation of adherence to treatment have been issued so far. Studies on adherence rates to antiretroviral therapy in people living with HIV have led to the development of many effective interventions to improve patient adherence to treatment. Objective: To assess adherence to HCV therapy among patients treated at the Infectious Diseases Clinic of the Hospital Nereu Ramos in Florianópolis, Santa Catarina, Brazil. Methods: A cross-sectional study on 123 patients undergoing pharmacological treatment for HCV was performed, which included all patients admitted during the study period. The Morisky-Green questionnaire was administered to assess compliance with HCV therapy. Qualitative variables were presented as absolute and relative values, whereas quantitative variables, as central tendency and dispersion. Pearson¿s chi-square test and the Student's t test were used to assess the correlation between qualitative variables. Prevalence ratios were estimated using the modified Poisson regression. Results: We evaluated 123 patients undergoing HCV treatment, of whom 89 (72.4%) were male, with a mean age of 51.7 (SD = 9.4) years. The Morisky-Green questionnaire revealed that 96 (78%) patients did not adhere to treatment. Factors affecting adherence included forgetting to take medications (50, 40.6%) and feeling uncomfortable to comply with the treatment (66, 53.65%). Of the 34 patients who underwent SVR test to assess the viral load, 30 had sustained virologic response, i.e., undetectable viral load, while 4 patients remained with detectable viral load. Conclusion: We concluded that adherence to HCV treatment is low, requiring multidisciplinary team monitoring to improve treatment. Nevertheless, most patients who undergo the full treatment present undetectable viral load after six months of treatment.
Although hepatitis C virus (HCV) was discovered in 1989, no formal guidelines for the evaluation of adherence to treatment have been issued so far. Studies on adherence rates to antiretroviral therapy in people living with HIV have led to the development of many effective interventions to improve patient adherence to treatment. Objective: To assess adherence to HCV therapy among patients treated at the Infectious Diseases Clinic of the Hospital Nereu Ramos in Florianópolis, Santa Catarina, Brazil. Methods: A cross-sectional study on 123 patients undergoing pharmacological treatment for HCV was performed, which included all patients admitted during the study period. The Morisky-Green questionnaire was administered to assess compliance with HCV therapy. Qualitative variables were presented as absolute and relative values, whereas quantitative variables, as central tendency and dispersion. Pearson¿s chi-square test and the Student's t test were used to assess the correlation between qualitative variables. Prevalence ratios were estimated using the modified Poisson regression. Results: We evaluated 123 patients undergoing HCV treatment, of whom 89 (72.4%) were male, with a mean age of 51.7 (SD = 9.4) years. The Morisky-Green questionnaire revealed that 96 (78%) patients did not adhere to treatment. Factors affecting adherence included forgetting to take medications (50, 40.6%) and feeling uncomfortable to comply with the treatment (66, 53.65%). Of the 34 patients who underwent SVR test to assess the viral load, 30 had sustained virologic response, i.e., undetectable viral load, while 4 patients remained with detectable viral load. Conclusion: We concluded that adherence to HCV treatment is low, requiring multidisciplinary team monitoring to improve treatment. Nevertheless, most patients who undergo the full treatment present undetectable viral load after six months of treatment.
Palavras-chave
Hepatite C - tratamento, Hepatite - pacientes - Santa Catarina, Avaliação de riscos de saúde