Grado de adherencia terapéutica a los fármacos del metabolismo óseo-mineral: ¿toman nuestros pacientes la medicación prescrita? Degree of therapeutic adherence to bone mineral metabolism drugs: Do our patients take the prescribed medication?

Abstract

Los fármacos del metabolismo óseo-mineral tienen gran importancia el tratamiento de los pacientes de hemodiálisis, pero desconocemos las preferencias, y el grado de conocimiento de estos fármacos. Los objetivos del estudio fueron conocer el grado de adherencia terapéutica a los fármacos del metabolismo oseo-mineral, e identificar los factores más relevantes que influyen en la adherencia a este tipo de tratamiento. Pacientes y métodos: Se realizó un estudio transversal en un Centro de hemodiálisis, incluyendo 106 pacientes. Utilizamos el cuestionario simplificado de adherencia a la medicación (SMAQ)¹ y un cuestionario específico sobre cumplimiento y preferencias, para conocer el grado de adherencia. Resultados: El 37,7% de los pacientes fue incumplidor según el cuestionario SMAQ. De ellos, el 34% no tomaba la medicación a la misma hora (PBone mineral metabolism drugs are of great importance in treating haemodialysis patients, but we are unaware of their preferences and degree of knowledge of these drugs. The aims of the study were to find out the degree of therapeutic adherence to bone mineral metabolism drugs and to identify the most relevant factors that influence adherence to this type of treatment. Patients and methods: A transversal study was carried out at a haemodialysis centre, including 106 patients. We used the simplified medication adherence questionnaire (SMAQ)¹ and a specific questionnaire on compliance and preferences, in order to find out the degree of adherence. Results: 37.7% of the patients were non-compliant, according to the SMAQ. Of these, 34% did not take the medication at the same time (P<0.000), 5.7% did not comply with the treatment at weekends (P<0.010), 13.2% stop taking the medication when they feel unwell (P<0.010); and in the last week, 18% acknowledged that they forgot the treatment 1 day (P= 0.001) and between 2-3 days (12,5%). 52% did not have preferences for any phosphorus chelant and 60.4% knew about their usefulness. The main reason for dislike was the increase in water consumption (16%), followed by the size of the tablet (15%) and lanthanum carbonate was the drug they liked least. Finally, 91% acknowledged that they had received dietary information. Conclusions: As conclusions of our study, 37.7% of the patients on the haemodialysis programme at our centre did not adhere to the prescribed treatment, according to the answers obtained in the SMAQ, and the degree of knowledge, information and/or understanding of the medical and dietary treatment prescribed to patients are very important factors in improving the degree of compliance, and therefore the active involvement of nursing staff is a key tool in order to achieve the therapeutic goal