Avaliação da Adesão Regime Terapêutico dos Utentes Seguidos na Consulta Externa de Psiquiatria do Centro Hospitalar Barlavento Algarvio

Abstract

International studies have shown that in general there is a low level of psychiatric treatment adherence (ART) and the reduction or abandonment of the therapy is related to several factors such as age, gender, education, cohabitation, income, unemployment or lack of job stability and polypharmacy. In Portugal, there is a dearth of information on therapy in psychiatric patients, which is a concern expressed in the National Mental Health 2007-2016. Thus, this study aims to assess the level of the users of psychiatric therapy followed in outpatient psychiatric Hospital Center Western Algarve (CHBA) and identify the factors that influence this adherence in order to adapt the plan of care to these clients for the promotion of effective management of the therapy. The sample consists of 61 individuals, corresponding to all users with psychiatric disorders who attended the consultation in the period 17 April to 5 May 2011, willing and able to participate in the study. A questionnaire was composed of socio-demographic and socio-economic, social status Index (Graff) and the scale of Measure Adherence to Treatment (MAT). The sample is characterized by individuals aged 24 to 76 years, mean 48 ± 12.9 years, 57.4% are women, only 26.2% of clients are married / cohabiting de facto while the remaining are single (45.9%), widowed (9.8%) or divorced / separated (18.0%), 80.3% do not work and source of income for retirement is 62.3%, 44.3% have level monthly income less than 250 Euros and 29.5% receiving 250 to 500 Euros, 80.3% live in their own home or rented. As for treatment, most users take 3-5 drugs (57.4%), 23% were not able to purchase all prescription drugs, 18% indicated transportation problems in the acquisition and 68.9% of the therapeutic benefits of the special arrangements of reimbursement. With regard to adherence to psychiatric therapy, the rate of MAT indicates that 50.8% of participants adhered to the therapeutic treatment, and the lower levels of adherence were observed in questions related to forgetfulness (4.52 ± 1.11), the time of taking the drug (4.62 ± 1.14) and the effect of the drug in their healing process (4.90 ± 1.11). Additionally it was found that the rate of MAT is influenced by age, education and social class, and the lower levels of adherence were seen in older individuals with lower education levels and lower social class. The results confirm that the level of psychiatric treatment adherence in this population is low. The conditioning factors established were age, educational level and social class and there were no significant influence of factors related to therapy and the acquisition of medicines. Thus, it is suggested that these factors are taken into account in planning actions to increase the psychiatric treatment adherence in this population.