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Adesão à terapêutica em doentes diabéticos tipo 2: estudo de caso numa farmácia em Almada
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Advisor(s)
Abstract(s)
O tratamento da diabetes tipo 2 pressupõe que o doente adira não só ao regime terapêutico
medicamentoso, mas também a medidas não farmacológicas, de gestão e de monitorização, que
controlam a doença, e evitam o desenvolvimento de complicações. A adesão à terapêutica é
fundamental para o sucesso terapêutico, permitindo alcançar uma melhor qualidade de vida no
doente. Nos últimos anos vários estudos científicos reportaram com maior ênfase a
problemática da não adesão à terapêutica, nos doentes crónicos e particularmente nos doentes
diabéticos de tipo 2. As suas principais consequências consistem no agravamento da
sintomatologia, no desenvolvimento de complicações, e nos aumentos dos custos nos serviços
de saúde.
O farmacêutico atua na primeira linha dos cuidados de saúde primários, e como tal exerce
um papel fundamental no acompanhamento e orientação do doente diabético tipo 2. É da sua
responsabilidade aconselhar, acompanhar e monitorizar estes doentes, adotando uma
comunicação clara e objetiva. A relevância do presente trabalho centra-se na importância de
identificar e analisar os principais fatores de risco que interferem na adesão à terapêutica no
doente diabético tipo 2, bem como dar a conhecer os métodos disponíveis para avaliar este
comportamento. Pretende-se ainda estudar as principais estratégias de intervenção farmacêutica
no processo de melhoria da adesão. As estratégias consideradas incluem as de ordem
educacional, comportamental, motivacional, as cognitivas e aquelas que promovem a
autogestão e a automonitorização. Para além da revisão bibliográfica sobre o tema, analisou-se
um caso clínico, que exemplifica alguns dos comportamentos típicos de não adesão à
terapêutica no doente diabético tipo 2. Concluiu-se na sua análise que existia a toma irregular
dos medicamentos, e o incumprimento de várias medidas terapêuticas não farmacológicas. A
intervenção farmacêutica permitiu uma melhoria na adesão ao regime medicamentoso e a
consciencialização do doente sobre a importância da prática de hábitos de vida saudáveis.
The treatment of type 2 diabetes assumes that the patient adheres not only to the drug treatment procedure, but also to non-pharmacological treatment wich has characteristics concerning management and monitoring, that contribute to control the disease and prevent the development of complications. Adherence to therapy is critical to the success, allowing the patient to achieve a better quality of life. In recent years, several scientific studies have reported with great emphasis the problem of non-adherence to therapy in chronic patients and particularly in patients with type 2 diabetes. The main consequences consist of worsening symptoms, the development of complications and increases in health services costs. The pharmacist works at the forefront of primary health care, and plays a key role in monitoring and guidance of patients with diabetes type 2. It is his responsibility to advise, survey and monitor these patients, adopting a clear and objective communication with them. This work focuses on the importance of identifying and analyzing the main risk factors that interfere with the adherence to therapy of this kind of patients, and to inform the methods available to evaluate this behavior. It also encompasses the study major pharmaceutical intervention strategies to improve patient attainment. The strategies considered include those of educational order, but also behavioral, motivational, cognitive and those that promote selfmanagement and self-monitoring. Besides scientific state-of-the-art review and compilation, this work also analyses a case study that exemplifies some of the typical behaviors of nonadherence to therapy of patients with type 2 diabetes. The main conclusions of this analysis shows an irregular medication taking and the negligence of several non-pharmacological therapeutic procedures. In this case, the pharmaceutical intervention allowed an improvement of drug regimen and patient awareness about the importance of healthy lifestyle habits.
The treatment of type 2 diabetes assumes that the patient adheres not only to the drug treatment procedure, but also to non-pharmacological treatment wich has characteristics concerning management and monitoring, that contribute to control the disease and prevent the development of complications. Adherence to therapy is critical to the success, allowing the patient to achieve a better quality of life. In recent years, several scientific studies have reported with great emphasis the problem of non-adherence to therapy in chronic patients and particularly in patients with type 2 diabetes. The main consequences consist of worsening symptoms, the development of complications and increases in health services costs. The pharmacist works at the forefront of primary health care, and plays a key role in monitoring and guidance of patients with diabetes type 2. It is his responsibility to advise, survey and monitor these patients, adopting a clear and objective communication with them. This work focuses on the importance of identifying and analyzing the main risk factors that interfere with the adherence to therapy of this kind of patients, and to inform the methods available to evaluate this behavior. It also encompasses the study major pharmaceutical intervention strategies to improve patient attainment. The strategies considered include those of educational order, but also behavioral, motivational, cognitive and those that promote selfmanagement and self-monitoring. Besides scientific state-of-the-art review and compilation, this work also analyses a case study that exemplifies some of the typical behaviors of nonadherence to therapy of patients with type 2 diabetes. The main conclusions of this analysis shows an irregular medication taking and the negligence of several non-pharmacological therapeutic procedures. In this case, the pharmaceutical intervention allowed an improvement of drug regimen and patient awareness about the importance of healthy lifestyle habits.
Description
Dissertação de Mestrado, Ciências Farmacêuticas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2016
Keywords
Adesão à terapêutica Diabetes tipo 2 Estratégias Intervenção farmacêutica Monitorização Adherence to therapy Type 2 diabetes Strategies Pharmaceutical intervention Monitoring