Grado de adherencia terapéutica a los fármacos del metabolismo óseo-mineral: ¿toman nuestros pacientes la medicación prescrita?

Abstract

Bone mineral metabolism drugs are of great importance in treating haemodialysis patients, but we are unaware of their preferences and degree of knowledge of these drugs. The aims of the study were to fi nd out the degree of therapeutic adherence to bone mineral metabolism drugs and to identify the most relevant factors that infl uence adherence to this type of treatment. Patients and methods: A transversal study was carried out at a haemodialysis centre, including 106 patients. We used the simplifi ed medication adherence questionnaire (SMAQ)1 and a specific questionnaire on compliance and preferences, in order to fi nd out the degree of adherence. Results: 37.7% of the patients were non-compliant, according to the SMAQ. Of these, 34% did not take the medication at the same time (P<0.000), 5.7% did not comply with the treatment at weekends (P<0.010), 13.2% stop taking the medication when they feel unwell (P<0.010); and in the last week, 18% acknowledged that they forgot the treatment 1 day (P= 0.001) and between 2-3 days (12,5%). 52% did not have preferences for any phosphorus chelant and 60.4% knew about their usefulness. The main reason for dislike was the increase in water consumption (16%), followed by the size of the tablet (15%) and lanthanum carbonate was the drug they liked least. Finally, 91% acknowledged that they had received dietary information.Conclusions: As conclusions of our study, 37.7% of the patients on the haemodialysis programme at our centre did not adhere to the prescribed treatment, according to the answers obtained in the SMAQ, and the degree of knowledge, information and/or understanding of the medical and dietary treatment prescribed to patients are very important factors in improving the degree of compliance, and therefore the active involvement of nursing staff is a key tool in order to achieve the therapeutic goal.