Factores relacionados con la adherencia a tratamientos de larga duración en adolescentes: Estudio descriptivo en un hospital terciario / Factors related to adherence to long-term treatment in adolescents. descriptive study in a tertiary hospital

Objetivo: Identificar los factores que pueden condicionar la adherencia a tratamientos de larga duración en adolescentes. Método: Estudio observacional, descriptivo y transversal realizado en el Campus Hospitalario Vall d'Hebron de Barcelona. Los participantes fueron adolescentes entre 12 y 18 años, con las siguientes condiciones: trasplantados de órganos sólidos, enfermedad oncohematológica, diabetes tipo 1, fibrosis quística o VIH+; así como sus cuidadores. Resultados: Participaron 153 adolescentes y 153 cuidadores. La media de edad de los adolescentes fue de 15 años (DE = 2) y el 54 % (83) eran varones. El 69 % (106) de los cuidadores eran mujeres. El 49 % (75) refirió saltarse el tratamiento alguna vez al mes o más frecuentemente; de ellos, el 92 % (69) conocía las consecuencias de no cumplirlo. Los diabéticos fueron el grupo que refirieron incumplimiento frecuente en menor porcentaje (25.6 %). Las causas principales de incumplimiento fueron el olvido (64 %), no disponer de la medicación (19 %) o cansarse de tomarla (11 %). El 39 % (59) de los cuidadores afirmaron que existían problemas de aceptación y cumplimiento por parte del adolescente. Se halló una mayor frecuencia de incumplimiento en pacientes con mayor número de fármacos y vías de administración. Las mujeres refirieron una mayor participación en las visitas de seguimiento. Conclusiones: Las variables asociadas a complejidad del tratamiento se relacionaron con incumplimiento frecuente. No hubo diferencias entre patologías en cuanto a las causas de incumplimiento referidas, hecho que podría facilitar el diseño de intervenciones transversales en cronicidad pediátrica. Las diferencias halladas entre sexos sugieren un estilo más participativo entre las adolescentes

Objetives: To identify the factors that can condition adherence to long-term treatment in adolescents. Method: An observational, descriptive and cross-sectional study carried out at the Vall d'Hebron Hospital Campus. Participants were adolescents between 12 and 18 years of age, with the following conditions: solid organ transplants, oncohematologic disease, type 1 diabetes, cystic fibrosis or HIV+ and their caregivers. Results: 153 adolescents and 153 caregivers participated. The mean age of adolescents was 15 years (SD = 2) and 54 % (83) were boys. 69 % (106) of the caregivers were women. 49 % (75) reported that they skipped treatment once a month or more frequently, of whom 92 % (69) knew the consequences of not doing so. Diabetics were the group that reported frequent noncompliance in a lower percentage (25.6 %). The main causes of noncompliance were forgetfulness (64 %), not having medication (19 %) or getting tired of taking it (11 %). 39 % (59) of the caregivers affirmed that there were problems of acceptance and compliance of the treatment by the adolescent. A higher frequency of noncompliance was found in patients with higher numbers of drugs and routes of administration. Women reported increased participation in follow-up visits. Conclusions: Variables associated with the complexity of treatment were related to frequent non-compliance. There were no differences between pathologies regarding the causes of noncompliance referred, which could facilitate the design of global interventions in pediatric chronicity. Differences found between sexes suggest a more participatory style and greater responsibility among women

Opinión de los profesionales sanitarios sobre la adherencia y manejo de tratamientos de larga duración en adolescentes / Opinion of health professionals on adherence and management of long-term treatments in adolescents

Objetivo. Conocer la opinión de los profesionales sanitarios sobre la adherencia y el manejo de tratamientos de larga duración en adolescentes en un hospital de tercer nivel. Método. Estudio observacional, descriptivo y transversal, realizado en el Hospital Universitari Vall d'Hebron de Barcelona, España. Los sujetos de estudio fueron los profesionales sanitarios que atienden a los adolescentes trasplantados de órganos sólidos, seropositivos, con enfermedad oncohematológica, diabetes o fibrosis quística. La recogida de datos se realizó mediante cuestionario autocumplimentado, elaborado específicamente para este estudio. Resultados. Participaron 105 profesionales (70 %). Un 80 % eran enfermeras. El 56 % consideró que el cumplimiento del tratamiento de los adolescentes era bueno. Un 43 % señaló que la adherencia no se abordaba bien. El 79 % de los profesionales no disponían de tiempo planificado para realizar educación sanitaria relacionada con el tratamiento. El 19.5 % de las enfermeras y el 72,2 % de los médicos indicaron disponer de instrumentos de evaluación de la adherencia. El 39 % de los participantes realizó propuestas de mejora. Conclusiones. Casi la mitad de los profesionales opina que la adherencia terapéutica no se aborda adecuadamente. Es importante la evaluación de la adherencia a los tratamientos para identificar causas de bajo cumplimiento e instaurar y evaluar intervenciones adecuadas (AU)

Objective. To assess opinion of health professionals about adherence and management of long-term treatments in adolescents in a tertiary hospital. Method. A cross-sectional study was carried out in the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were health professionals who care adolescents with solid organ transplant, hematologic disease, diabetes, cystic fibrosis or HIV+. Data collection was performed by self-administered questionnaire, developed specifically for this study. Results. A total of 105 professionals (70 %) participated in the study, 80 % were nurses, 56 % of them indicated that treatment compliance was good. 43 % indicated that adherence was not addressed well and 79 % of professionals did not have planned time to conduct health education related to treatment. 19.5 % of nurses and 72.2 % of physicians reported having adherence assessment tools. 39 % of participants made ??suggestions for improvement. Conclusions. Almost half of the professional indicate that the adherence is not adequately addressed. It is important to evaluate adherence to treatment to identify causes of low compliance and establish and evaluate appropriate interventions (AU)

[OPINION OF HEALTH PROFESSIONALS ON ADHERENCE AND MANAGEMENT OF LONG-TERM TREATMENTS IN ADOLESCENTS]. / Opinión de los profesionales sanitarios sobre a adherencia y manejo de tratamientos de larga duración en adolescents.

OBJECTIVE: To assess opinion of health professionals about adherence and management of long-term treatments in adolescents in a tertiary hospital. METHOD: A cross-sectional study was carried out in the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were health professionals who care adolescents with solid organ transplant, hematologic disease, diabetes, cystic fibrosis or HIV+. Data collection was performed by self-administered questionnaire, developed specifically for this study. RESULTS: A total of 105 professionals (70%) participated in the study, 80% were nurses, 56% of them indicated that treatment compliance was good. 43% indicated that adherence was not addressed well and 79% of professionals did not have planned time to conduct health education related to treatment. 19.5% of nurses and 72.2% of physicians reported having adherence assessment tools. 39% of participants made suggestions for improvement. CONCLUSIONS: Almost half of the professional indicate that the adherence is not adequately addressed. It is important to evaluate adherence to treatment to identify causes of low compliance and establish and evaluate appropriate interventions.