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    Mensuração Da Adesão Aos Medicamentos Imunossupressores Em Pacientes Pediátricos No Pós-Transplante Renal
    (Universidade Federal de São Paulo (UNIFESP), 2017-02-24) Silva, Ana Carolina Maximo [UNIFESP]; Roza, Bartira De Aguiar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The adherence to the therapeutic treatment after a transplant is a multidimensional phenomenon determined by the conjunction of five agents as follows: the health-care staff, social and economic factors, the treatment itself, the patient and the disease. Although there is not one method that is considered to be efficient, there are various methods described in the literature to detect non-adherence in post-transplanted patients. Objective: Measure the adherence to the immunosuppressive medication in renal post-transplant by using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). Method: The sample comprised 156 post-transplanted renal pediatric patients who had been at home for at least four weeks after being discharged from hospital. They were evaluated by BAASIS as to the ingestion of prescribed drugs, number of days using the correct dose of the prescribed drugs, taking the prescribed drugs within 25% of the prescribed schedule for doing so, pause on the medication intake, time of exceeding ingestion of 24 hours, dose alterations by the patient’s own decision, complexity of the prescribed doses, patient’s treatment perception, creatinine levels and the registry of admission to the hospital by acute cellular rejection as confirmed through biopsy. Results: The results showed 66,7% of adherence to immunosuppressant medication and 33,3% of non-adherence. In the presence of a caregiver the adherence was of 68,2% and without the caregiver it dropped to 25%. A prevalence of boys was observed at 60,9% (p=0,0081), difference in average of creatinine by gender (p=0,044), type of treatment: Hemodialysis (p=0,010) and Conservative (p=0,035), surgical procedure (p=0,004), type of transplant (p<0,001) and hospitalization due to acute cellular rejection (p=0,005). Conclusions: The present study enabled the identification of some specificities of the pediatric population in renal post-transplant regarding non-adherence to medication. It showed that the higher the non-adherence rates to medication, the worse are the parents/guardians and patients’ adherence perception. Through such findings it is understood how necessary it is to review medication adherence, the existence of barriers to such adherence and the presence of a caregiver. Thus, it is necessary to monitor the adherence and its barriers in order to design follow-up strategies focusing in educational actions that promote self-care and support to adherence. Such strategies are essential to the effectiveness of medication adherence in post-transplanted renal pediatric patients which in turn will alter results and improve patient survival.