Estrategia de intervención para mejorar la adherencia terapéutica al tratamiento farmacológico en pacientes con Diabetes Mellitus Tipo 2.

Abstract

The objective was to improve the therapeutic adherence to the pharmacological treatment of people with type 2 diabetes mellitus (DM2), through an intervention strategy in the El Dorado neighborhood of the city of Puyo, during the period from January to June 2019. It was carried out: an analytical, longitudinal, prospective, quasi-experimental study (before / after study without a control group). Clinical and demographic characteristics were evaluated. The intervention consisted of a structured educational strategy, aimed at patients, based on the design of the intervention strategy developed by the doctor, of the Postgraduate in Family and Community Medicine of the I Cohort of the Superior Polytechnic School of Chimborazo. A knowledge test about the disease, its care and the adherence test of Morisky Green Levine was initially applied. After 6 months and after the intervention, the tests are applied again. At the same time, the degree of glycemic control of the patients through glycosylated hemoglobin was evaluated. A total of 33 patients with a diagnosis of DM2 were included, representing 8.2% of the total assigned population (402). Age 62.3 ± 10.03 years. Diagnostic time of 10 ± 5.19 years. 69% of the female sex. Distribution according to educational level: secondary 48.4%, none 18.1%, superior 15.2%, primary 12.1%. Treatment: Oral hypoglycemic agents 66.67%, Insulin 18.18%, none 6%. Baseline adhesion = 18.18 and after intervention 63.6% (p = 0.000). Baseline self-care knowledge = 54% post = 90% (p = 0.00). Knowledge about metabolic control 66.7% post = 90.9% (p = 0.02). Knowledge about baseline complications = 66.7% post = 93.9% (p = 0.04). Adequate basal metabolic control (Ale) = 54.5% post = 66.7% (p = 0.2). There was improvement in the level of adherence and knowledge with statistical significance, but a non-significant improvement in metabolic control. It is recommended to support programs of self-control, self-care and education that help improve the quality of life of people with DM2.