Asociación entre adherencia a tratamiento y nivel de compensación del asma moderado en pacientes entre 6 y 14 años pertenecientes al CESFAM de Olmué de la V región durante el período de Septiembre del 2013 y Noviembre del 2014
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2015
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Universidad Andrés Bello
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Resumen
INTRODUCCIÓN: El asma es una enfermedad crónica de la vía aérea, que se
caracteriza por presentar inflamación de esta, períodos de obstrucción bronquial parcial
o totalmente reversible e hiperreactividad bronquial en personas susceptibles a esta
inflamación, asociándose a episodios reiterados de sibilancias, disnea, opresión torácica
y tos, específicamente durante la noche o la madrugada. La clasificación según la Guía
Clínica MINSAL 2011, se divide en leve, moderado y severo. El presente estudio tiene
como objetivo determinar la asociación entre adherencia al tratamiento y el nivel de
compensación del asma moderado, de acuerdo a las dispensaciones en la farmacia del
CESFAM de Olmué de manera directa y controlando por variables moduladoras del
presente estudio, como sexo femenino y masculino, edad, exposición al humo de tabaco
y estado nutricional.
MATERIAES Y MÉTODOS: Se realizó un estudio observacional, transversal,
retrospectivo, descriptivo-asociativo, revisando los tarjeteros de control de Sala IRA de
CESFAM Olmué durante el periodo de Septiembre 2013 a Noviembre 2014. Se
revisaron 53 pacientes con Asma Moderada, con edades entre 6 años cumplidos a
menores de 15 años, que se realizan tratamiento en el CESFAM de Olmué por la
enfermedad de asma y han sido diagnosticados de asma moderado. Se utilizó la variable
dependiente de compensación de asma moderado, variable independiente de adherencia
al tratamiento y variables moduladoras de sexo femenino y masculino, edad, exposición
al humo de tabaco y estado nutricional. Para realizar el análisis estadístico se utilizó la
prueba exacta de Fisher.
RESULTADOS: De la población de estudio, los resultados encontrados fueron los
siguientes: De un total de 53 pacientes, 15.09% adhiere al tratamiento, mientras que un
84.91% no adhirió. 79.25% presentó asma compensado, mientras que un 20.75%
presentó asma no compensado. De los 8 pacientes que adhirieron al tratamiento, el
87.5% presentó asma compensada, mientras que un 12.5% no lo estaba. De los 45
pacientes que no adhirieron al tratamiento, 77.7% estaba compensado, mientras que el 22.2% no lo estaba. En relación al sexo, un 39,62% de la población corresponde a sexo
femenino y un 60,38% a sexo masculino. En relación a la edad, de 6-9 años en un 24,5%
y 10-14 años equivalentes al 75,47% de la población; exposición al humo de tabaco
ausente 79,25% y presente en un 20,75% y finalmente estado nutricional normal en un
39.62% y alterado un 60,38% de la población. La prueba exacta de Fisher arrojó un
resultado que no fue significativo. Finalmente, no se evidencia asociación entre
adherencia al tratamiento según las dispensaciones en farmacia y el nivel de
compensación del asma moderado en relación a las variables moduladoras sexo
femenino y masculino, edad categorizada, exposición a humo de tabaco y estado
nutricional (presencia o ausencia de sobrepeso-obesidad).
CONCLUSIONES: No existe asociación estadísticamente significativa entre falta de
adherencia al tratamiento y el nivel de compensación de asma moderado en la población
de estudio, según sexo femenino y masculino, edad, exposición al humo de tabaco y
estado nutricional. Se sugiere realizar modificación a los tarjeteros, específicamente en
los puntos de medición de exposición a tabaco y estado nutricional. La información
obtenida es de relevancia para el CESFAM, por lo que sería conveniente realizar un
nuevo estudio aumentando el tamaño de la población e incluyendo nuevas variables de
estudio, con un análisis estadístico multivariado.
INTRODUCTION: Asthma is an airways chronic disease, characterized by the inflammation of those, periods of bronchus obstruction partial or totally reversible and bronchial hyperreactivity in people susceptible to this inflammation, being associated with recurring episodes of wheezing, breathlessness, chest tightness and coughing, specifically during the night or dawn. The classification according to the MINSAL 2011 Clinical Guide divides in light, moderate and severe. This study aims to determine the relation between adherence to treatment and the level of compensation of the moderate asthma, according to the dispensations at the pharmacy of Olmués CESFAM directly and controlling for control variables of this study, such as sex, age, exposure to cigarette smoke and nutritional state. MATERIALS AND METHODS: An observational, transversal, retrospective, descriptive-associative study was done, reviewing the IRA room control card holders of Olmués CESFAM during the period between September 2013 and November 2014. 53 patients with moderate asthma were reviewed, between the ages of 6 and 15, that are treated at Olmués CESFAM for Asthma disease and have been diagnosed with moderate asthma. The moderate asthma compensation dependent variable, adherence to treatment independent variable and sex, age, exposure to cigarette smoke and nutritional state modulating variables were used. For the statistical analysis Fisher’s exact test was used. RESULTS: From the samples obtained, the results found were the following: Of a total of 53 patients, 15.09% adhere to the treatment, while 84.91% do not adhere to it. 79.25% presented controlled asthma, while 20.75% presented non controlled asthma. Of the 8 patients that adhere to the treatment, 87.5% presented controlled asthma, while 12.5% were not. Of the 45 patients that did not adhere to the treatment, 77.7% were controlled, while 22.2% were not. In relation with the female sex 39,62% and masculine 60,38%; In age from 6-9 years a 24,5% and 10-14 years equivalent to 75,47%; exposure to cigarette smoke absent 79,25% and present 20,75% and finally normal nutritional state in 39.62% and altered in 60,38%. Fisher’s exact test yield a result that was not significative. Finally, there is no evidence of association between adherence to the treatment according to the dispensations of the pharmacy and the level of compensation in moderate asthma in relation with the sex, categorized age, exposure to cigarette smoke and nutritional state (presence or absence of obesity-overweight) modulating variables. CONCLUSIONS: There is no statistically significative relation between the lack of adherence to the treatment and the level of compensation of the symptoms of moderate asthma in the studied population according to sex, age, exposure to cigarette smoke or nutritional state. A modification to the card holders is recommended, specifically in the points of measure of exposure to cigarette smoke and nutritional state. The information obtained is relevant for the CESFAM, so it would be advisable to conduct a new study increasing the size of the sample and including new variables of study.
INTRODUCTION: Asthma is an airways chronic disease, characterized by the inflammation of those, periods of bronchus obstruction partial or totally reversible and bronchial hyperreactivity in people susceptible to this inflammation, being associated with recurring episodes of wheezing, breathlessness, chest tightness and coughing, specifically during the night or dawn. The classification according to the MINSAL 2011 Clinical Guide divides in light, moderate and severe. This study aims to determine the relation between adherence to treatment and the level of compensation of the moderate asthma, according to the dispensations at the pharmacy of Olmués CESFAM directly and controlling for control variables of this study, such as sex, age, exposure to cigarette smoke and nutritional state. MATERIALS AND METHODS: An observational, transversal, retrospective, descriptive-associative study was done, reviewing the IRA room control card holders of Olmués CESFAM during the period between September 2013 and November 2014. 53 patients with moderate asthma were reviewed, between the ages of 6 and 15, that are treated at Olmués CESFAM for Asthma disease and have been diagnosed with moderate asthma. The moderate asthma compensation dependent variable, adherence to treatment independent variable and sex, age, exposure to cigarette smoke and nutritional state modulating variables were used. For the statistical analysis Fisher’s exact test was used. RESULTS: From the samples obtained, the results found were the following: Of a total of 53 patients, 15.09% adhere to the treatment, while 84.91% do not adhere to it. 79.25% presented controlled asthma, while 20.75% presented non controlled asthma. Of the 8 patients that adhere to the treatment, 87.5% presented controlled asthma, while 12.5% were not. Of the 45 patients that did not adhere to the treatment, 77.7% were controlled, while 22.2% were not. In relation with the female sex 39,62% and masculine 60,38%; In age from 6-9 years a 24,5% and 10-14 years equivalent to 75,47%; exposure to cigarette smoke absent 79,25% and present 20,75% and finally normal nutritional state in 39.62% and altered in 60,38%. Fisher’s exact test yield a result that was not significative. Finally, there is no evidence of association between adherence to the treatment according to the dispensations of the pharmacy and the level of compensation in moderate asthma in relation with the sex, categorized age, exposure to cigarette smoke and nutritional state (presence or absence of obesity-overweight) modulating variables. CONCLUSIONS: There is no statistically significative relation between the lack of adherence to the treatment and the level of compensation of the symptoms of moderate asthma in the studied population according to sex, age, exposure to cigarette smoke or nutritional state. A modification to the card holders is recommended, specifically in the points of measure of exposure to cigarette smoke and nutritional state. The information obtained is relevant for the CESFAM, so it would be advisable to conduct a new study increasing the size of the sample and including new variables of study.
Notas
Tesis (Kinesiología)
Palabras clave
Asma, Clasificación, Obstrucción de las Vías Aéreas, Terapia, Tabaco, Enfermedades Crónicas