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[Therapeutic adherence of patients with cardiovascular risk in primary care. REAAP project]
J Espinosa García1, L Aliaga Gutiérrez2, F López Simarro3
1Medicina Familiar y Comunitaria, Centro de Salud Villanueva de la Serena Norte, Badajoz. Excoordinador del Grupo de Trabajo de Adherencia Terapéutica e Inercia Clínica y miembro del Grupo de Trabajo de Gestión del Medicamento, Inercia Clínica y Seguridad del Paciente de SEMERGEN. Jefe de estudios UDMAFYC , Don Benito-Villanueva de la Serena, Badajoz, España.
Objective:
To describe the perceptions and daily experiences of primary care (PC) physicians in dealing with the lack of therapeutic adherence in patients with cardiovascular risk, as well as their expectations and possible areas for improvement.
Material And Methods:
A qualitative study (within the framework of the REAAP project: Network of Experts in Adherence in Primary Care) carried out in several autonomous communities in Spain using an open-ended questionnaire completed by PC physicians and analyzed using the framework analysis method to guide the coding of the topics.
Results:
Eighteen physicians participated, and three main themes were identified from their responses: an approach to adherence during clinical practice, barriers that hinder the appropriate adherence, and interventions to improve it. The strategies most frequently mentioned to facilitate patients' therapeutic adherence were improving physician-patient communication and continuity of care, involving community pharmacies, and simplifying treatment by prescribing drugs in fixed combinations.
Conclusions:
There is no single ideal strategy to facilitate therapeutic adherence, and it is necessary to combine several interventions to optimize it. The first step is to understand the problems and the tools available. Initiatives such as the REAAP project are an important means to improve patient adherence, and for healthcare personnel to recognize the importance that this issue deserves.
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