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Efecto de un programa de atención farmacéutica en la adherencia y persistencia de la medicación, la presión arterial
Jeannie K Lee1, Karen A Grace, Allen J Taylor
1Department of Pharmacy, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
JAMA
|November 15, 2006
Resumen
Un programa integral de atención farmacéutica mejoró significativamente la adherencia y persistencia de la medicación en pacientes ancianos. Esto condujo a reducciones significativas en la presión arterial (PA), destacando la efectividad del programa.
Área de la Ciencia:
- Medicina Geriátrica La medicina geriátrica es una especialidad de la medicina geriátrica.
- Cardiología Cardiología.
- Farmacología Farmacología.
Sus antecedentes:
- La mala adherencia a la medicación tiene un impacto negativo en los resultados de la farmacoterapia.
- Los pacientes ancianos con factores de riesgo coronario a menudo administran múltiples medicamentos, lo que aumenta el riesgo de no adherencia.
Objetivo del estudio:
- Evaluar la efectividad de un programa integral de atención de farmacia para mejorar la adherencia a la medicación.
- Evaluar el impacto del programa en la presión arterial (PA) y los niveles de colesterol de lipoproteínas de baja densidad (LDL-C).
Principales métodos:
- Un estudio prospectivo multifásico en el que participaron 200 pacientes de edad avanzada (≥65 años) que tomaban ≥4 medicamentos crónicos.
- Una fase de intervención incluyó la educación de la medicación y el seguimiento del farmacéutico, seguido de la aleatorización a la atención farmacéutica continua o la atención habitual.
- Los resultados primarios midieron la adherencia y persistencia a la medicación; los resultados secundarios incluyeron cambios en la presión arterial y el LDL-C.
Principales resultados:
- La adherencia a la medicación aumentó del 61,2% al 96,9% después de la intervención de 6 meses (P<.001).
- La presión arterial sistólica y LDL-C mostraron mejoras significativas después de la intervención.
- Se observó una adherencia sostenida (95,5%) y una reducción significativa de la presión arterial (-6,9 mm Hg) en el grupo de atención farmacéutica en comparación con la atención habitual (P<.001 y P=.04, respectivamente).
Conclusiones:
- Un programa de atención de farmacia mejora efectivamente la adherencia a la medicación y la persistencia en pacientes ancianos.
- El programa conduce a reducciones clínicamente significativas en la presión arterial.
- La interrupción del programa de atención farmacéutica resultó en una disminución de la adherencia y persistencia de la medicación.
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