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Adherencia al tratamiento terapéutico en pacientes con enfermedad de Chagas del Estado de Morelos.
Resumen
Introduction. Chagas disease is endemic in the state of Morelos. The available medication is benznidazole, however adherence to treatment is generally not monitored by medical personnel to verify the accomplishment.
Objective. To evaluate the adherence to therapeutic treatment and the risk factors associated with its compliance and the registry of adverse effects in patients with Chagas disease in the state of Morelos.
Material and Methods. Follow-up study in 20 chronic asymptomatic patients. Adherence was assessed using the Morisky-Green structured test, a questionnaire was applied to record the risk factors related to adherence to treatment, home visits were made to the cases, and personalized interviews were conducted in 8 cases to obtain information on positive and negative factors associated with treatment.
Results. Sixty five percent of patients were adherent to treatment and 35% were non-adherent due to non-compliance behaviors. Seven cases (35%) had some type of adverse reaction to the drug that did not warrant treatment discontinuation, except for two cases that had severe reactions. Statistical analysis of the variables in adherent and non-adherent cases showed no statistical association between adherence and variables of socioeconomic level, school level, access to medical service, marital status, age and sex.
Conclusions. Adherence assessment in patients with a confirmed diagnosis of Chagas' disease in the state of Morelos provided information to follow up on treatment compliance and record of adverse effects.
Introducción. La enfermedad de Chagas es endémica en el estado de Morelos. El medicamento disponible es el benznidazol, sin embargo generalmente la adherencia al tratamiento no es vigilado por el personal médico para verificar su cumplimiento.
Objetivo. Evaluar la adherencia al tratamiento terapéutico y los factores de riesgo asociados con su cumplimiento y el registro de efectos adversos en pacientes con enfermedad de Chagas del estado de Morelos.
Material y Métodos. Estudio de seguimiento en 20 pacientes asintomáticos. La adherencia se evaluó mediante la aplicación del cuestionario estructurado de Morisky-Green, se aplicó un cuestionario para registrar los factores de riesgo relacionados con el apego al tratamiento, se hicieron visitas domiciliarias y se hicieron entrevistas personalizadas a 8 casos para obtener información sobre factores positivos y negativos asociados al tratamiento.
Resultados. El 65% de los pacientes fueron adherentes al tratamiento y 35% fueron no adherentes debido a conductas de incumplimiento. Siete casos (35%) presentaron algún tipo de reacción adversa al medicamento que no ameritó la suspensión del tratamiento, excepto dos casos que tuvieron reacciones severas. El análisis estadístico de las variables en los casos adherentes y no adherentes no mostró asociación estadística entre la adherencia y las variables de nivel socioeconómico, escolaridad, acceso al servico médico, estado civil, edad y sexo. Conclusiones. La evaluacion de la adherencia en pacientes con diagnóstico confirmado de enfermedad de Chagas del estado de Morelos, aportó información para dar seguimiento al cumplimiento del tratamiento y registrar los efectos adversos.
Referencias
World Health Organization. Chagas disease in Latin America: an epidemiological update based on 2010 estimates. World Health Organization Weekly Epidemiological Record. 2015 Jun; 90(6): 33-44.
Schmunis GA & Yadon ZE. Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop. 2010 Jul-Aug; 115 (1-2):14-21.
Bern C & Montgomery SP. An estimate of the burden of Chagas disease in the United States. Clin Infect Dis. 2009 Sep; 49 (5): e52-e54.
Basile L, Jansá JM, Carlier Y, Salamanca DD, Angheben A, Bartoloni A et al. Chagas disease in European countries: the challenge of a surviellance system. Eurosurveillance. 2011 Sep; 16(37): 19968.
Manne-Goehler J, Reich MR, Wirtz VJ. Access to care for Chagas disease in the United States: a health systems analysis. Am J Trop Med Hyg. 2015 May; 93(1): 5.
Manne JM, Snively CS, Ramsey JM, Ocampo M, Barnighausen T, Reich MR. Barriers to treatment access for Chagas disease in Mexico. PLOS Neglect Trop Dis. 2013 Oct; 7 (10): e2488.
Ramsey JM, Elizondo-Cano M, Sánchez-González G, Peña-Nieves A, Figueroa-Lara A. Opportunity cost for early treatment of Chagas disease in México. PLOS Negl Trop Dis. 2014 Apr; 8(4): e2776.
Boletín Epidemiológico, Sistema Nacional de Vigilancia Epidemiológica, Sistema Único de Información, DGE/SSA, http://www.epidemiologia.salud.gob.mx/informes/index.html 2016.
Ribeiro I, Sevsick AM, Alves F, Diap G, Don R et al. New, improved treatments for Chagas disease: from the R&D pipeline to the patients. PLOS Neglect Trop Dis. 2009 Jul; 3 (7):e484.
Bern C. Antitrypanosomal therapy for chronic Chagas´disease. N Engl J Med. 2011 Jun 30; 364(26): 2527-34.
Viotti R, Alarcon de Noya B, Araujo-Jorge T. Towards a paradigm shift in the treatment of chronic Chagas disease. Animicrob Agents Chemother. 2014; 58: 635-9.
Morillo CA, Marin-Neto JA, Avezum A. Randomized trial of benznidazole for chronic Chagas´disease cardiomyopathy. N Engl J Med. 2015 Oct; 373 (1):1295-1306.
Jackson Y, Alirol E, Getaz L, Wolff H, Combescure C, Chappuis F. Tolerance and safety of nifurtimox in patients with chronic Chagas disease. Clin Infect Dis. 2010 Nov; 51(10):e69-75.
Viotti R, Vigliano C, Lococo B, Alvarez MG, Bertocchi G, Armenti A. Side effects of benznidazole as treatment in chronic Chagas disease: fears and realities. N Engl J Med. 2015 Oct; 373:1295-1306.
Perez-Molina JA, Sojo-dorado J, Norman F. Nifurtimox therapy for Chagas disease does not cause hypersensitivity reactions in patients with such previous adverse reactions during benznidazole treatment. Acta Trop. 2013 Aug; 127(2): 101-4.
Tornheim JA, Lozano DF, Gilman RH, Castellon M, Solano MA, Sullca W, Torrico F, Bern C. Improved completion rates and characterization of drug reactions with an intensive Chagas disease treatment program in rural Bolivia. PLOS Neglect Trop Dis. 2013 Sep; 7 (9):e2407.
DasNeves Pinto A, da Costa V, Rodriguez Coura J, da Silva SA, Verissimo AC, Santos LC, Gomes A Jr, de Macedo RC. Clinical follow-up of responses to treatment with benznidazol in Amazon: A cohort study of acute Chagas disease. PLOS One. 2013 May; 8 (5): e64450.
Yurelis GA. La adherencia terapéutica. Rev Cubana Med Gen Integr. 2001; 17(5): 502-505.
Renato Z, John DM, Jorge PV, José FA. Percepción de la adherencia a tratamientos en pacientes con factores de riesgo cardiovascular. Rev Fac Nac Salud Pública [online], 2012 Mayo-Agosto; 30(2), 163-174.
Cramer Jam Manson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed?. A novel assessment technique. JAMA. 1989; 261(22):3273-3277.
Larrea P, Mir M. Adherencia al tratamiento en el paciente anciano. Información terapéutica del Sistema Nacional de Salud 2004; 28(5): 1453-5. http://www.msc.es/farmacia/infmedic
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986 Jan; 24(1):67-74.
Peralta ML & Carbajal P. Adherencia al tratamiento. Rev Cent Dermatol Pascua 2008 Sep-Dic; 17(3): 84-88.
Tornheim JA, Lozano DF, Gilman RH, Castellon M, Solano MA, Sullca W, Torrico F, Bern C. Improved completion rates and characterization of drug reactions with an intensive Chagas disease treatment program in rural Bolivia. PLOS Negl Trop Dis. 2013 Sept; 7 (9); e2407.
Arrivillaga-Quintero M. Análisis de las barreras para la adherencia terapéutica en mujeres Colombianas con VIH/SIDA: cuestión de derechos de salud. Salud Pública Mex. 2010 Jul-Aug; 52(4):350-6.
Pinazo MJ, Muñoz J, Posada E, López-Chejade P, Gallego M. Tolerance of benznidazole in treatment of Chagas´disease in adults. Antimicrob Agents Chemother. 2010 Nov; 54(11): 4896-99
Pinazo MJ, Guerrero L, Posada E, Rodriguez E, soy D, Gascon J. Benznidazole-related adverse drug reactions and their relationship to serum drug concentrations in patients with chronic Chagas disease. Antimicrob Agents Chemother. 2013 Jan; 57 (1):390-5.
Apt B, Werner. Guías clínicas de la enfermedad de Chagas: Parte I. Introducción y epidemiología. Rev. Chil. infectol., Jun 2008; 25(3):189-193.
Perez-Mazliah DE, Alvarez MG, Cooley G, Lococo BE, Bertocchi G, Petti M, Albareda MC, Armenti AH, Tarleton RL, Laucella SA, Viotti R. Sequential combined treatment with allopurinol and benznidazole in the chronic phase of Trypanosoma cruzi infection: a pilot study. J Antimicrob Chemother. 2013 Feb; 68 (2): 424-37.
Alvarez MG, Vigliano C, Lococo B, Petti M, Bertocchi G, Viotti R. Seronegative conversion after incomplete benznidazole treatment in chronic Chagas disease. Trans R Soc Trop Med Hyg. 2012 Oct; 106 (10): 636-8.
Bermudez J, Davies C, Simonazzi A, Real JP, Palma S. Current drug therapy and pharmaceutical challenges for Chagas disease. Acta Tropica. 2016 Apr; 156: 1-16.
Alvarez MG, Hernández Y, Bertocchi G, Fernández M, Lococo B, Ramirez JC, Cura C, Albizu Cl, Schijman A, Abril M, Sosa-Estani S, Viotti R. New scheme of intermittent benznidazole administration in patients chronically infected with Trypanosoma cruzi: a pilot short-term follow-up study with adult patients. Animicrob Agents Chemother. 2015 Oct; 60(2): 833-7.
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