Comparação da adesão medicamentosa no Diabetes tipo 2 com e sem transplante renal
Data
2021-03-24
Autores
Procópio, Fernanda de Oliveira [UNIFESP]
Orientadores
Schirmer, Janine [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A realização do transplante renal (TXR) é considerada uma alternativa terapêutica de bom prognóstico para a Doença Renal Crônica. O Diabetes Mellitus tipo 2 (DM2) não controlado é uma das principais causas de lesão renal. A adesão a terapêutica é essencial para uma promissora evolução do transplante e minimização das comorbidades causadoras e/ou associadas a esse processo. A partir desses conhecimentos a pesquisa em questão busca compreender se a realização do TXR alterou a adesão aos medicamentos para o DM2. Objetivo: Analisar a adesão ao tratamento medicamentoso em pessoas com Diabetes Mellitus do Tipo 2 submetidas à TXR e comparar com pessoas com DM do tipo 2 não submetidas ao TXR. Método: Estudo comparativo. Os locais do estudo foram no Centro de Diabetes da Unifesp (Grupo 1) e no Ambulatório de Pós-Transplante Renal do Hospital do Rim e da Hipertensão (Grupo 2) ambos na cidade de São Paulo. Foram incluídos pacientes maiores de 18 anos com diagnósticos de DM2 prévios ao transplante e que estivessem em uso de medicações para o controle do DM2. A coleta de dados foi de outubro de 2017 a outubro de 2018. Foram aplicados aos participantes Termo de Consentimento Livre e Esclarecido, questionário sócio clínico, Medida de Adesão ao Tratamento Medicamentoso no Diabetes Mellitus – antidiabéticos orais e insulina, e escala de ansiedade e depressão. O registro do projeto no Comitê de Ética e Pesquisa (CEP) é CEP/UNIFESP n: 0712/2017. Resultado: Amostra composta de 107 pacientes (Grupo 1: 56 e Grupo 2: 51) com maior prevalência de homens, com média de idade de 63,3 anos, da região metropolitana de São Paulo, aposentados, casados, com sobrepeso ou obesidade, sem sintomas de ansiedade e depressão. A média de medicações diferentes utilizada foi 8,7. Os pacientes autorreferiam ter adesão a medicações para o DM de modo similar nos dois grupos. Os resultados da hemoglobina glicada variaram entre 8,3 e 8,7% entre os grupos. Discussão: Observamos comportamentos semelhantes entre os grupos e superestimação da adesão autorreferida. A equipe multidisciplinar pode auxiliar nesse processo, ajustando também de forma personalizada as medicações receitadas aos pacientes. Conclusão: Conclui-se que o TXR não alterou a adesão ao tratamento medicamentoso do DM2.
Introduction: Performing kidney transplantation (KT) is considered a therapeutic alternative with a good prognosis for Chronic Kidney Disease. Uncontrolled type 2 diabetes mellitus (DM2) is one of the main causes of kidney injury. Adherence to therapy is essential for a promising evolution of the transplant and minimization of the comorbidities that cause and / or are associated with this process. Based on this knowledge, the research in question seeks to understand whether the realization of the KT changed adherence to drugs for DM2. Objective: To analyze adherence to drug treatment in people with Type 2 Diabetes Mellitus submitted to KT and to compare it with people with DM2 not submitted to KT. Method: Comparative study. The study locations were the Unifesp Diabetes Center (Group 1) and the Post-Kidney Transplant Clinic at the Hospital do Rim e Hipertensão (Group 2), both in São Paulo city. Patients older than 18 years diagnosed with DM2 prior to transplantation and who were using medications to control DM2 were included. Data collection was from October 2017 to October 2018. Participants were given an Informed Consent Form, socio-clinical questionnaire, Measure of Adherence to Drug Treatment in Diabetes Mellitus - oral antidiabetics and insulin, and an anxiety and depression scale. The project register by the Ethics and Research Committee (Comitê de Ética e Pesquisa - CEP) is CEP/UNIFESP n: 0712/2017. Result: Sample composed of 107 patients (Group 1: 56 and Group 2: 51) with a higher prevalence of men, with an average age of 63.3 years, from the São Paulo metropolitan region, retired, married, overweight or obese, without symptoms of anxiety and depression. The average of different medications used was 8.7. Patients self-reported having adherence to medications for DM in a similar way in both groups. The results of glycated hemoglobin varied between 8.3 and 8.7% between groups. Discussion: We observed similar behaviors between groups and overestimation of self-reported adherence. The multidisciplinary team can assist in this process, also adjusting the medications prescribed to patients in a personalized way. Conclusion: It is concluded that the KT did not change the adherence to the medication treatment of DM2.
Introduction: Performing kidney transplantation (KT) is considered a therapeutic alternative with a good prognosis for Chronic Kidney Disease. Uncontrolled type 2 diabetes mellitus (DM2) is one of the main causes of kidney injury. Adherence to therapy is essential for a promising evolution of the transplant and minimization of the comorbidities that cause and / or are associated with this process. Based on this knowledge, the research in question seeks to understand whether the realization of the KT changed adherence to drugs for DM2. Objective: To analyze adherence to drug treatment in people with Type 2 Diabetes Mellitus submitted to KT and to compare it with people with DM2 not submitted to KT. Method: Comparative study. The study locations were the Unifesp Diabetes Center (Group 1) and the Post-Kidney Transplant Clinic at the Hospital do Rim e Hipertensão (Group 2), both in São Paulo city. Patients older than 18 years diagnosed with DM2 prior to transplantation and who were using medications to control DM2 were included. Data collection was from October 2017 to October 2018. Participants were given an Informed Consent Form, socio-clinical questionnaire, Measure of Adherence to Drug Treatment in Diabetes Mellitus - oral antidiabetics and insulin, and an anxiety and depression scale. The project register by the Ethics and Research Committee (Comitê de Ética e Pesquisa - CEP) is CEP/UNIFESP n: 0712/2017. Result: Sample composed of 107 patients (Group 1: 56 and Group 2: 51) with a higher prevalence of men, with an average age of 63.3 years, from the São Paulo metropolitan region, retired, married, overweight or obese, without symptoms of anxiety and depression. The average of different medications used was 8.7. Patients self-reported having adherence to medications for DM in a similar way in both groups. The results of glycated hemoglobin varied between 8.3 and 8.7% between groups. Discussion: We observed similar behaviors between groups and overestimation of self-reported adherence. The multidisciplinary team can assist in this process, also adjusting the medications prescribed to patients in a personalized way. Conclusion: It is concluded that the KT did not change the adherence to the medication treatment of DM2.
Descrição
Citação
PROCÓPIO, Fernanda de Oliveira. Comparação da adesão medicamentosa no Diabetes tipo 2 com e sem transplante renal. São Paulo, 2021. 103 f. Dissertação (Mestrado em Enfermagem) – Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, 2021.