Qualidade de vida e adesão medicamentosa entre hipertensos assistidos em um Centro de Atenção Secundária no Norte de Minas Gerais, Brasil

Abstract

The state of Minas Gerais has established Centers of Secondary Health Care - Hiperdia Centers, in 2009, with the mission to extend longevity and improve the quality of life through interventions capable of reducing morbidity and mortality from hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease. High blood pressure is known as the main responsible for the morbidity and mortality of cardiovascular diseases in Brazil and worldwide. This study aimed to assess quality of life and medication adherence among hypertensive assisted in a Secondary Center of Attention in Health, in northern Minas Gerais, Brazil. The type of research is transversal, quantitative, observational and analytical. Data collection was conducted in compliance with ethical principles of research involving humans and the project was approved by Unimontes Research Ethics Committee. Data were collected on a Hiperdia Center along to people age 18 and over, seen between the months from June to December 2013. The location data collection is characterized as a Center of Secondary Health Care, which is a reference for hypertensive in 16 municipalities in the Micro-area São Francisco-Brasilia de Minas, Minas Gerais, Brazil. A semi-structured questionnaire was used as an instrument of data collection, containing questions about the socioeconomic and demographic profile, quality of life (WHOQOL-bref and Minichal-Brazil) and medication adherence (Batalla test). Biological data were collected during routine clinical examination by the physician member of the research and Hiperdia's worker. We analyzed the quality of life (WHOQOL-bref) under medication adherence, by chi-squared tests and Mann Whitney. In another interpretation it was analyzed quality of life (Minichal-Brazil), with bivariate Pearson correlation and Student t test. The statistics were performed in the Software Package for Social Sciences (S.P.S.S. for Windows, version 22.0) program, with a significance level of 5% and 95% confidence interval. The majority of participants were women (71%), mean age 60 years old (± 13.37). Participants with greater understanding of the disease were considered adherent to antihypertensive medications (81%), and had better quality of life in the environment domain, which assesses access to information, health services and financial resources, of the WHOQOL-bref (p=0.013). In the psychological domain, those with medication adherence, better enjoy life, have greater ability to concentrate and acceptance of physical appearance (p <0.05). Minichal-Brazil instrument showed that the worst quality of life was correlated with higher systolic blood pressure (p = 0.006) in contrast to the betterrelated quality of life and higher monthly percapta income, in the somatic manifestations domain (p = 0.042). Patients reported that the treatment of hypertension and its treatment affects the quality of life (56%), in different shades, rather, medium or long. The results show the important relationship between quality of life and medication adherence, which demonstrates the need of clinical case management beyond the act of prescribing medications. It is also shown that hypertension is a disease that impacts negatively on the quality of life of individuals. In this sense, investment in health education could contribute, since it allows to increase knowledge about the disease, reflecting in adherence to medication and better quality of life.