Evaluación de un programa de atención farmacéutica basado en la adherencia y seguridad de pacientes ambulatorios con artritis reumatoide en tratamiento con Adalimumab : Hospital del Salvador
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Fecha
2023
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Idioma
es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
La Artritis Reumatoide (AR) es una enfermedad autoinmune, que cursa con
inflamación crónica, afectando múltiples tejidos y órganos, principalmente la
membrana sinovial de las articulaciones. Además, se caracteriza por el dolor,
inflamación, tumefacción, calor, rigidez de las articulaciones y la incapacidad
física que causa en las personas que la padecen, provocando distintos grados de
alteraciones y limitaciones que afectan de manera significativa las actividades
cotidianas, no solo en la capacidad funcional física, sino también en las
actividades sociales, psicológicas y económicas.
En este sentido, el objetivo terapéutico en la AR es conseguir la remisión de la
enfermedad, apuntando a lograr el mejor control posible de la misma, es decir,
una respuesta satisfactoria, para lo cual se utilizan diferentes medidas tanto
farmacológicas como no farmacológicas. Dentro de las medidas farmacológicas
se encuentran las siguientes familias de medicamentos: Analgésicos,
Antiinflamatorios no Esteroideos (AINEs), Glucocorticoides, Fármacos
antirreumáticos modificadores de la enfermedad (FAME) sintéticos y nuevas
opciones terapéuticas más prometedoras para el tratamiento de esta
enfermedad, como lo son los medicamentos biológicos tales como Adalimumab,
que es un anticuerpo monoclonal tipo Ig G1 totalmente humanizado que se une
específicamente al factor de necrosis tumoral (TNF-alfa).
Es por esto, que se implementó un estudio que tuvo por objetivo evaluar la
aplicación de un programa de atención farmacéutica basado en la adherencia y
seguridad de pacientes ambulatorios con Artritis Reumatoide en tratamiento con
Adalimumab en el Hospital del Salvador. Dicho estudio fue de tipo cuantitativo
cuasiexperimental prospectivo y se llevó a cabo mediante 4 etapas, las cuales
fueron: Oferta del servicio, entrevista inicial, entrevista de seguimiento y
entrevista final.
Luego de evaluar la adherencia al medicamento biológico, se observó que el
100% de los pacientes era cumplidor con su tratamiento, no así, en relación a los
medicamentos orales de la Artritis, en donde, al inicio del programa se observó
un 70% de adherencia y al término de este un 90%. Con respecto a las reacciones
adversas, estas se presentaron en el 50% de los pacientes, siendo las más
frecuentes el dolor y ardor en el sitio de inyección con un 80% y las infecciones
del tracto respiratorio con un 20%. Por otro lado, la encuesta de satisfacción
arrojó que 7 de los enunciados tuvieron una calificación del 100%, es decir,
valoración “excelente”.
A la luz de los resultados, se concluye que no hubo falta de adherencia al
tratamiento con Adalimumab, ya que, su adherencia al inicio del programa fue del
100%, así como tampoco, hubo relación entre las reacciones adversas del
medicamento con la adherencia, pese a que se presentaron en el 50% de los
pacientes, sin embargo, respecto a la adherencia en la farmacoterapia
complementaria de la Artritis, esta mejoró en un 20% (de 70% a 90%) al finalizar
el programa, gracias a las estrategias educativas realizadas (material educativo).
Finalmente se determinó gracias a la encuesta de satisfacción usuaria, que los
pacientes quedaron muy satisfechos y agradecidos de la atención farmacéutica
que recibieron, sugiriendo que se implementara esta atención en todos los
pacientes del Hospital y no solo en los con Artritis Reumatoide.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation, affecting multiple tissues and organs, mainly the synovial membrane of the joints. In addition, it is characterized by pain, inflammation, swelling, heat, joint stiffness and the physical disability it causes in people who suffer from it, causing different degrees of alterations and limitations that significantly affect daily activities, not only in physical functional capacity, but also in social, psychological and economic activities. In this sense, the therapeutic objective in RA is to achieve remission of the disease, aiming to achieve the best possible control of the disease, that is, a satisfactory response, for which different pharmacological and non pharmacological measures are used. Among the pharmacological measures are the following families of drugs: Analgesics, Non-steroidal Anti-inflammatory drugs (NSAIDs), Glucocorticoids, Synthetic disease-modifying antirheumatic drugs (DMARDs) and new more promising therapeutic options for the treatment of this disease, such as biological drugs such as Adalimumab which is a fully humanized Ig G1 monoclonal antibody that specifically binds to the TNF-alpha tumor necrosis. For this reason, a study was implemented that aimed to evaluate the application of a pharmaceutical care program based on adherence and safety of outpatients with Rheumatoid Arthritis treated with Adalimumab at the Hospital del Salvador. This study was a prospective quasi-experimental quantitative study and was carried out through 4 stages, which were: Service offer, initial interview, follow-up interview and final interview. After evaluating adherence to the biological medication, it was observed that 100% of the patients were compliant with their treatment, but not in relation to oral arthritis medications, where, at the beginning of the program, 70% adherence was observed and at the end of the program 90%. Adverse reactions occurred in 50% of patients, with the most frequent being pain and burning at the injection site (80%) and respiratory tract infections (20%). On the other hand, the satisfaction survey showed that 7 of the statements had a rating of 100%, that is, an "excellent" rating. The results show the conclusion that there was no lack of adherence to treatment with Adalimumab, since its adherence at the beginning of the program was 100%, as well as there was no relationship between adverse reactions of the drug and adherence, despite the fact that they occurred in 50% of the patients, however, with respect to adherence in complementary pharmacotherapy of Arthritis, This improved by 20% (from 70% to 90%) at the end of the programme, thanks to the educational strategies carried out (educational material). Finally, it was determined, thanks to the user satisfaction survey, that patients were very satisfied and grateful for the pharmaceutical care they received, suggesting that this care be implemented in all patients of the Hospital and not only in those with Rheumatoid Arthritis.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation, affecting multiple tissues and organs, mainly the synovial membrane of the joints. In addition, it is characterized by pain, inflammation, swelling, heat, joint stiffness and the physical disability it causes in people who suffer from it, causing different degrees of alterations and limitations that significantly affect daily activities, not only in physical functional capacity, but also in social, psychological and economic activities. In this sense, the therapeutic objective in RA is to achieve remission of the disease, aiming to achieve the best possible control of the disease, that is, a satisfactory response, for which different pharmacological and non pharmacological measures are used. Among the pharmacological measures are the following families of drugs: Analgesics, Non-steroidal Anti-inflammatory drugs (NSAIDs), Glucocorticoids, Synthetic disease-modifying antirheumatic drugs (DMARDs) and new more promising therapeutic options for the treatment of this disease, such as biological drugs such as Adalimumab which is a fully humanized Ig G1 monoclonal antibody that specifically binds to the TNF-alpha tumor necrosis. For this reason, a study was implemented that aimed to evaluate the application of a pharmaceutical care program based on adherence and safety of outpatients with Rheumatoid Arthritis treated with Adalimumab at the Hospital del Salvador. This study was a prospective quasi-experimental quantitative study and was carried out through 4 stages, which were: Service offer, initial interview, follow-up interview and final interview. After evaluating adherence to the biological medication, it was observed that 100% of the patients were compliant with their treatment, but not in relation to oral arthritis medications, where, at the beginning of the program, 70% adherence was observed and at the end of the program 90%. Adverse reactions occurred in 50% of patients, with the most frequent being pain and burning at the injection site (80%) and respiratory tract infections (20%). On the other hand, the satisfaction survey showed that 7 of the statements had a rating of 100%, that is, an "excellent" rating. The results show the conclusion that there was no lack of adherence to treatment with Adalimumab, since its adherence at the beginning of the program was 100%, as well as there was no relationship between adverse reactions of the drug and adherence, despite the fact that they occurred in 50% of the patients, however, with respect to adherence in complementary pharmacotherapy of Arthritis, This improved by 20% (from 70% to 90%) at the end of the programme, thanks to the educational strategies carried out (educational material). Finally, it was determined, thanks to the user satisfaction survey, that patients were very satisfied and grateful for the pharmaceutical care they received, suggesting that this care be implemented in all patients of the Hospital and not only in those with Rheumatoid Arthritis.
Notas
Seminario (Química Farmacéutica)
Palabras clave
Atención Farmacéutica, Adherencia Terapéutica, Artritis Reumatoide, Tratamiento