Desafios para a atenção em saúde: adesão ao tratamento e controle metabólico em pessoas com diabetes mellitus tipo 2 no município de Passos, MG / Challenges to health care: treatment adherence and metabolic control in people with type 2 diabetes mellitus in the municipality of Passos, MG

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

05/07/2011

RESUMO

This sectional study aimed to evaluate treatment adherence and metabolic control in people with diabetes mellitus from the city of Passos, state of Minas Gerais, Brazil. Sample was comprised of 423 people with type 2 diabetes mellitus who were enrolled in 17 Family Health Units and were selected through stratified random sampling technique. Data collection was conducted by field researchers, through directed interviews at home, using four instruments: questionnaire containing sociodemographic, clinical and therapeutic variables; Measure of Treatment Adherence; Questionnaire of Food Consumption Frequency; and International Questionnaire of Physical Activity. Descriptive statistics and Fisher\ s exact test for associations were used for analysis. Results showed that subjects were predominantly female; aged an average of 62.4 years and 4.3 years of study; and received an average of 3.2 Brazilian minimum wages. Majority had less than ten years after diagnosis; were overweight; values for abdominal circumference above of recommended levels; and had altered values of blood pressure. With regard to laboratory tests, excepted regarding the total cholesterol, results showed abnormal values, and the average for HbA1c was of 8.1 %. Related to the prevalence of treatment adherence in patients with DM, 357 (84.4%) of them had adherence to drug treatment, 248 (58.6%) to physical activity and only 13 (3.1%) to diet. By analyzing simultaneously the three elements investigated, it was found that only 1.4% showed full adherence to DM treatment. Regarding drug treatment to control diabetes, the prevalence of adherence was higher for males (85.8%), for subjects aged over 60 years (87.0%), with educational level between four and eight years of study (85%), and disease duration greater than or equal to ten years (86.9%). Regarding diet, women (3.2%), subjects under the age of 60 years (4.3%), with more than eight years of study (6.5%), with family income less than three Brazilian minimum wages (3.7%) and more than ten years of disease (4%) had a higher prevalence of treatment adherence. Prevalence of adherence to physical activity was also higher among women (61%), in people aged less than 60 years (59.3%), with less than four years of study (60.4%), with family income less than three minimum wages (59.6%) , and with disease duration greater than or equal to ten years (59.7%). By adopting the minimum level of significance of 5% (p<0.05), there was no statistically significant difference between researched variables and prevalence of adherence to DM treatment, excepted regarding the total cholesterol which presented an associated statistically significant with adherence to diet (p=0.036) and glycated hemoglobin values with physical activity (p=0.006). The chance of subjects with the recommended value for cholesterol make adherence to diet is nearly five times the chance of people in poor lipid control. The chance of subjects with poor glycemic control make adherence to physical activity is almost twice the chance of those with adequate glycemic control. Considering results, urgent implementation of strategies for effective education in the city of Passos is recommend, being in view the comprehensive care in diabetes, with the result indicator users\ adherence to treatment.

ASSUNTO(S)

diabetes mellitus diabetes mellitus enfermagem health service nursing serviços de saúde terapêutica therapeutics

ACESSO AO ARTIGO

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