Journal Information
Vol. 20. Issue 3.
Pages 220-227 (May - June 2006)
Vol. 20. Issue 3.
Pages 220-227 (May - June 2006)
Originales
Open Access
Determinantes del cumplimiento terapéutico en personas mayores de 60 años en España
Determinants of the adherence to therapeutic plan in elderly Spaniards, over 60 years of age
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Rafael Tuesca-Molinaa,
Corresponding author
rtuesca@uninorte.edu.co

Correspondencia: Rafael Tuesca-Molina. Universidad del Norte. Departamento de Salud Familiar y Comunitaria. Km 5 Antigua carretera a Puerto Colombia. Barranquilla. Colombia.
, Pilar Guallar-Castillónb, José Ramón Banegas-Banegasb, Auxiliadora Graciani-Pérez Regaderab
a Universidad del Norte, Departamento de Salud Familiar y Comunitaria, División Ciencias de la Salud, Barranquilla, Colombia
b Universidad Autónoma de Madrid, Departamento de Medicina Preventiva, Salud Pública y Microbiología, Madrid, España
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Resumen
Objetivo

Identificar los factores asociados al cumplimiento terapéutico en varones y mujeres hipertensos conocidos.

Material y métodos

Estudio poblacional de 4.009 sujetos a partir de los datos del estudio «Hipertensión arterial y otros factores de riesgo en la población de 60 años y más de España ». Entrevista en el domicilio que recoge información sobre cumplimiento terapéutico, variables sociodemográficas, estilo de vida, uso de servicios de salud y calidad de vida relacionada con la salud.

Resultados

En varones el cumplimiento terapéutico según las zonas estudiadas (odds ratio [OR] área rural = 3,9 frente a OR litoral cantábrico = 1,9) y con respecto a la salud general (OR=1,01). En mujeres, las cumplidoras con nivel escolar bajo (OR=1,8), la calidad de vida en el componente físico (OR=1,02) y visitas mensuales al domicilio (OR=3,0). Las no cumplidoras autorreportan 2 enfermedades crónicas (OR=0,6).

Conclusiones

El cumplimiento terapéutico se relaciona con diferencias de género, regionales, educacionales y en la calidad de vida. Es recomendable diseñar estrategias diferenciadas por las anteriores variables a fin de incrementar el cumplimiento terapéutico.

Palabras clave:
Adhesión
Ancianos
Hipertensión
Abstract
Objective

To identify factors associated with the adherence to a therapeutic plan of awareness of hypertension.

Material and Methods

The data of the study: «arterial Hypertension and other factors of risk in the elderly (≥ 60 years) Spanish population». This was a population-based survey of 4.009 older Spaniards. Information for this survey was obtained thorough household personal interviews to evaluate if these determining factors are independent of socio-demographic variables, the use of health system, lifestyles and the quality of life related to health.

Results

In men, the adherence to a therapeutic plan according to the regions studied (OR Rural = 3.9; OR Cantabrian = 1.9). Beside general health (OR=1.01). With respect to the women, the ones that complied with the therapeutic plan more frequently had a low scholastic level (OR=1.8), physical condition (OR=1.02), and had more frequent home medical visits monthly (OR=3.0). The women with poor adherence had two chronic illnesses (OR=0.6)

Conclusions

There are regional differences, gender, educational and to measure health-related quality of life. This demonstrates poor adherence, so the strategy should be directed toward in this variables mentioned.

Key words:
Adherence
Elderly
Hypertension
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Bibliografía
[1.]
World Health Organization.
Adherence to long-term therapies. Evidence for action.
WHO, (2003),
[2.]
G.A. Hamilton.
Measuring adherence in a hypertension clinical trial.
Eur J Cardiovasc Nurs, 2 (2003), pp. 219-228
[3.]
R.T. Anderson, M. Ory, S. Cohen, J.S. McBride.
Issues of aging and adherence to health interventions.
Control Clin Trials, 21 (2000), pp. 171S-183S
[4.]
G. Nichols-English, S. Poirier.
Optimising adherence to pharmaceutical care plans.
J Am Pharm Assoc, 40 (2000), pp. 475-485
[5.]
M. Monane, R.L. Bohn, J.H. Gurwitz, R.J. Glynn, R. Levin, J. Avorn.
Compliance with antihypertensive therapy among elderly Medicaid enrolees: the role of age, gender and race.
Am J. Public Health, 86 (1996), pp. 1805-1808
[6.]
M.A. Fischer, J. Avorn.
Economic implications of evidence-based prescribing for hypertension: can better care cost less?.
JAMA, 291 (2004), pp. 1850-1856
[7.]
E.A. Bayliss, J.F. Steiner, D.H. Fernald, L.A. Crane, D.S. Main.
Descriptions of barriers to self-care by persons with comorbid chronic diseases.
Ann Fam Med, 1 (2003), pp. 15-21
[8.]
K. Grumbach.
Chronic illness, comorbidities, and the need for medical generalism.
Ann Fam Med, 1 (2003), pp. 4-7
[9.]
F. Villar-Álvarez, J.R. Banegas, F. Rodríguez-Artalejo.
Las enfermedades cardiovasculares y sus factores de riesgo en España: hechos y cifras.
ERGON, (2003),
[10.]
G.L. Bakris, H.R. Black, W.C. Cushman, L.A. Green, J.L. Izzo Jr, et al.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
JAMA, 289 (2003), pp. 2560-2572
[11.]
J.R. Banegas.
Epidemiología de la hipertensión arterial en personas mayores de 60 años en España.
Anales de la Real Academia Nacional de Medicina, (2002),
[12.]
B. Williams, N.R. Poulter, M.J. Brown, M. Davis, G.T. McInnes, J.F. Potter, et al.
British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary.
[13.]
D.E. Morisky, L.W. Green, D.M. Levine.
Concurrent and predictive validity of a self-reported measure of medication adherence.
Med Care, 24 (1986), pp. 67-74
[14.]
Encuesta Nacional de Salud de España 1997. Madrid: Ministerio de Sanidad y Consumo; 1999.
[15.]
E. Gil-López, R. Jiménez GP, C. Pérez-Andrés, F. Vargas-Marcos.
Estudio de los estilos de vida de la población adulta española.
Artegraf, S.A., (1992),
[16.]
Unitat de Recerca en Serveis Sanitaris. Manual de puntuación de la versión Española del cuestionario de Salud SF-36. Barcelona: Institut Municipal d’Investigació Mèdica; 1998.
[17.]
España-Portugal 21(990). 2000. Poitiers-France, Michelin Ediciones. Ref type: Map.
[18.]
M. Krousel, P. Muntner, A. Jannu, K. Desalvo, R. Re.
Reliability of a medication adherence measure in an outpatient setting.
Am J Med Sci, 330 (2005), pp. 128-133
[19.]
E. Poluzzi, P. Strahinja, A. Vargiu, G. Chiabrando, M.C. Silvani, D. Motola, et al.
Initial treatment of hypertension and adherence to therapy in general practice in Italy.
Eur J Clin Pharm, 61 (2005), pp. 603-609
[20.]
K. Lowry, T. Dudley, E. Oddone, H. Bosworth.
Intentional and unintentional nonadherence to antyhypertensive medication.
Ann Pharm, 39 (2005), pp. 1198-1203
[21.]
F. Benavides, M. Rodríguez, A. Arjol, M. Mas, J.J. Rodríguez, J.L. Tovar.
Pacientes hipertensos mal controlados: variables relacionadas con el tiempo hasta modificar el tratamiento (estudio HIMOT: hipertensión y modificación del tratamiento).
Hipertension, 21 (2004), pp. 442-447
[22.]
E. Yiannakopoulou, J. Papadopulos, D. Cokkinos, T. Mountokalakis.
Adherence to antihypertensive treatment: a critical factor for blood pressure control.
Eur J Cardiovasc Prev Rehabil, 12 (2005), pp. 243-249
[23.]
P. Wang, R.L. Bohn, E. Knight, R.J. Glynn, H. Mogun, J. Avorn.
Non compliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors.
J Gen Intern Med, 17 (2002), pp. 504-511
[24.]
S. Shea, D. Misra, M.H. Ehrlich, L. Field, C.K. Francis.
Correlates of nonadherence to hypertension treatment in an inner-city minority population.
Am J Public Health, 82 (1992), pp. 1607-1612
[25.]
G. Ogedegbe, C.A. Mancuso, J.P. Allegrante, M.E. Charlson.
Development and evaluation of a medication adherence self-efficacy scale in hypertensive African-American patients.
J Clin Epidemiol, 56 (2003), pp. 520-529
[26.]
C. Salzman.
Medication compliance in the elderly.
J Clin Psychiatry, 56 (1995), pp. 18-22
[27.]
X. Du.
Prevalence, treatment, control, and awareness of high blood pressure and the risk of stroke in Northwest England.
Prev Med, 30 (2000), pp. 288-294
[28.]
K. Reynolds, D. Gu, P. Muntner, X. Wu, J. Chen, G. Huang, et al.
Geographic variations in the prevalence, awareness, treatment and control of hypertension in China.
J Hypertens, 21 (2003), pp. 1273-1281
[29.]
B.M. Egan, D.T. Lackland, N.E. Cutler.
Awareness, knowledge, and attitudes of older Americans about high blood pressure: implications for health care policy, education, and research.
Arch Intern Med, 163 (2003), pp. 681-687
[30.]
W.H. Pan, H.Y. Chang, W.T. Yeh, S.Y. Hsiao, Y.T. Hung.
Prevalence, awareness, treatment and control of hypertension in Taiwan: results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996.
J Hum Hypertens, 15 (2001), pp. 793-798
[31.]
M.J. Clark, C. Curran, A. Noji.
The effects of community health nurse monitoring on hypertension identification and control.
Public Health Nursing, 17 (2000), pp. 452-459
[32.]
S. De Henauw, D. De Bacquer, W. Fonteyne, M. Stam, M. Kornitzer, G. De Backer.
Trends in the prevalence, detection, treatment and control of arterial hypertension in the Belgian adult population.
J Hypertens, 16 (1998), pp. 277-284
[33.]
M.A. Tedesco, G. Di Salvo, S. Caputo, F. Natale, G. Ratti, D. Iarussi, et al.
Educational level and hypertension: how socioeconomic differences condition health care.
J Hum Hypertens, 15 (2001), pp. 727-731
[34.]
T.C. Oliveira, T.L. Araujo.
Mecanismos desenvolvidos por idosos para enfrentar a hipertensâo arterial.
Rev Esc Enferm USP, 36 (2002), pp. 276-281
[35.]
A. Coca.
Evolución del control de la hipertensión arterial en atención primaria en España Resultados del estudio Controlpres 2003.
Hipertensión, 22 (2005), pp. 5-14
[36.]
R. Nuesch, K. Schroeder, T. Dieterle, B. Martina, E. Battegay.
Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: a prospective case-control study.
BMJ, 323 (2001), pp. 142-146
[37.]
J.R. Banegas, F. Rodríguez-Artalejo, A. Graciani Pérez-Regadera, J.J. De la Cruz-Troca, F. Villar-Álvarez.
Beneficios potenciales del control de la hipertensión.
Hipertensión, 19 (2002), pp. 19-27
[38.]
T. Landenpera, H. Kyngas.
Levels of compliance shown by hypertensive patients and their attitude toward their illness.
J Adv Nur, 34 (2001), pp. 189-195
[39.]
A. Coca.
Grado de control de la hipertensión arterial en España: ¿dónde estamos?.
Hipertensión, 21 (2004), pp. 385-387
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