Factors associated with non-adherence to drug therapy in people with substance-related disorders¹
Abstract
Objective: to identify the factors associated with non-adherence to drug therapy by people with substance-related disorders in treatment at Centers for Psychosocial Attention of alcohol and other drugs III. Method: a cross-sectional observational study conducted from April to November 2018, with 89 people (78 men and 11 women) with substance-related disorders. The data were collected by structured interview with application of the instruments: Measure of Adherence to Treatment, Addiction Severity Index Version 6, Level of knowledge, Medication Regimen Complexity Index and own elaboration; were submitted to descriptive and inferential quantitative analysis. Results: of the total number of participants, 56.2% did not adhere to drug therapy. Non-adherence was more frequent in people with clinical and psychiatric comorbidities, depressive symptoms, anxiety and altered sense perception. There was significance between non-adherence and history of treatment numbers and higher frequency of substance use. Conclusion: non-adherence to drug therapy was higher than expected and is associated with sociodemographic, clinical, mental and pharmacological factors. In substance-related disorders, non-adherence is complex due to the common characteristics of this condition, such as compulsion, cleavage and lack of insight.
1Manuscript is originated from the thesis entitled: ADHERENCE TO DRUG THERAPY BY PEOPLE IN TREATMENT IN PSYCHOSOCIAL CARE CENTERS - ALCOHOL AND DRUGS. Federal University of Paraná (UFPR).
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References
Bozkurt M. Neuroscientific Basis of Treatment for Substance Use Disorders. Noro Psikiyatr Ars. 2022 dec; 59 (1): 75-80. Doi: 10.29399/npa.28172.
Shuey B, Suda KJ, Halbisen A, Wen H, Wharam JF, Rosland AM, et al. Anti-hypertensive medication use among people with and without substance use disorders. Journal of general internal medicine. 2024 fev; 39(3): 508 - 510. Doi: 10.1007/s11606-023-08543-3.
Elowe J, Vallat J, Castelao E, Strippoli MF, Gholam M, Ranjbar S, et al. Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder. Int J Bipolar Disord. 2022 dec; 10 (1): 31. Doi: 10.1186/s40345-022-00280-6.
World Health Organization. Adherence to long-term therapies. Evidence for action [Internet]. Geneva: WHO; 2003. [Cited 2022 Mar 17]. Available from: http://www.who.int/chp/knowledge/publications/adherence_report/en/.
Capistrano FC, Maftum MA, Alcântara CB, Ferreira ACZ, Maftum GJ. Dimensões que interferem na adesão à medicação nos transtornos relacionados às substâncias: revisão integrativa. Cogitare Enferm. 2019; 24: e58170. Doi: http://dx.doi.org/10.5380/ce.v24i0.58170.
Cordioli AV, Gallois CB, Isolan L. Psicofármacos: Consulta rápida. 6a ed. Porto Alegre: Armed; 2023.
American Psychiatric Association. DSM V. Manual diagnóstico e estatístico de transtornos mentais - DSM-5. 5° ed. Porto Alegre: Artmed: 2014.
Soares RG da S, Araújo G de L, Santos MX dos, Melo LR de, Martinho NJ. Association of psychopharmaceuticals with other therapies: The care of the chemical dependent from an interprofessional perspective. Braz. J. Hea. Rev. 2020 jul; 3(4):8919-37.Doi: 10.34119/bjhrv3n4-137.
Di Lorenzo R, Perrone D, Montorsi A, Balducci J, Rovesti S, Ferri P. Atitude em relação à terapia medicamentosa em um centro comunitário de saúde mental avaliada pelo Drug Attitude Inventory. Adesão preferencial do paciente . 2020;14:995-1010. Doi: https://doi.org/10.2147/PPA.S251993.
Bidargaddi N, Schrader G, Myles H, Schubert KO, Kasteren Y van, Zhang T, et al. Demonstration of automated non-adherence and service disengagement risk monitoring with active follow-up for severe mental illness. Aust N Z J Psiquiatria. 2021 oct; 55(10): 976-982. Doi: 10.1177/0004867421998800.
Mgweba-Bewana L, Belus JM, Ipser J, Magidson JF, Joska JA. Examining the association of alcohol use and psychotropic medication adherence among women with severe mental illness in South Africa. Psychiatry Research. 2021 oct; 304:114127. Doi: https://doi.org/10.1016/j.psychres.2021.114127.
Carvalho LF, Rodrigues LA, Pandossio JE, Galassi AD. Análise Crítica Sobre Medicamentos Prescritos para o Uso Problemático de Crack. Psic: Teor e Pesq. 2021; 37: e372515. Doi: https://doi.org/10.1590/0102.3772e372515.
Alcântara CB de, Ferreira ACZ, Capistrano FC, Kaled M, Vale CCF., Maftum MA. Conhecimento da pessoa com transtornos mentais sobre o tratamento medicamentoso. Rev Enferm UFSM. 2020 abr; 10: e24. Doi: https://doi.org/10.5902/2179769238607.
Hird R, Radhakrishnan R, Tsai J. A systematic review of approaches to improve medication adherence in homeless adults with psychiatric disorders. Front. Psychiatry. 2024 jan; 14: 1339801. Doi: https://doi.org/10.3389/fpsyt.2023.1339801.
Burnier M. The role of adherence in patients with chronic diseases. Review Article. 2023 jan; 119: 1-5. Doi: https://doi.org/10.1016/j.ejim.2023.07.008.
Kessler F, Cacciola J, Alterman A, Faller S, Souza-Formigoni ML, Cruz ML, et al. Psychometric properties of the sixth version of the addiction severity index (ASI-6) in Brazil. Revista Brasileira de Psiquiatria. 2012 mar; 34(1): 24-33. Doi: 10.1590/S1516-44462012000100006.
Borba LO, Capistrano FC, Ferreira ACZ, Kalinke LP, Mantovani MF, Maftum MA. Adaptation and validation of the measuring treatment adherence for mental health. Revista Brasileira de Enfermagem. 2018; 71(5): 2243-50. Doi: http://dx.doi.org/10.1590/0034-7167-2017-0796.
Fröhlich SE, Dal Pizzol TS, Mengue SS. Instrumento para avaliação do nível de conhecimento da prescrição na atenção primária. Rev. Saúde Pública. 2010 dez; 44(6): 1046-1054. Doi: https://doi.org/10.1590/S0034-89102010000600009.
Melchiors AC, Correr CJ, Fernández-Llimos F. Tradução e validação para o português do Medication Regimen Complexity Index. Arq. Bras. Cardiol. 2007 out; 89(4): 210-218. Doi: https://doi.org/10.1590/S0066-782X2007001600001.
Muthulingam D, Bia J, Madden LM, Farnum SO, Barry DT, Altice FL. Using nominal group technique to identify barriers, facilitators, and preferences among patients seeking treatment for opioid use disorder: a needs assessment for decision making support. J Subst Abuse Treat. 2019 may; 100: 18-28. Doi: 10.1016/j.jsat.2019.01.019.
Walton KM, Herrmann ES. Medication Adherence in Tobacco Cessation Clinical Trials. Addiction Neuroscience. 2023 jun; 6:100069. Doi:10.1016/j.addicn.2023.100069.
Neto PAVR. Benefícios e limitações do tratamento apenas com medicação no manejo de transtornos psiquiátricos. Braz. J. Hea. Rev. [Internet]. 2023 Nov. 11 [citado em 7 de mar 2025];6(6):27458-71. Available from: https://doi.org/10.34119/bjhrv6n6-073.
Laranjeira C, Carvalho D, Valentim O, Moutinho L, Morgado T, Tomás C, et al. Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis. Int J Environ Res Public Health. 2023 fev; 20(5): 3869. Doi: 10.3390/ijerph20053869.
Volkow ND, Blanco C. Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention. World Psychiatry. 2023 jun; 22(2):203-229. Doi: 10.1002/wps.21073..
Silva SN, Lima MG, Ruas CM. Uso de medicamentos nos Centros de Atenção Psicossocial: análise das prescrições e perfil dos usuários em diferentes modalidades do serviço. Ciênc. Saúde Coletiva. 2020 jul; 25(7). Doi: https://doi.org/10.1590/1413-81232020257.23102018.
Schmidt SJ, Wurmbach VS, Lampert A, Bernard S, HIOPP-6 Consortium; Haefeli W. Individual factors increasing complexity of drug treatment – a narrative review. Eur J Clin Pharmacol. 2020 apr; 76(6): 745-754. Doi: 10.1007/s00228-019-02818-7.
Wakai E, Ikemura K, Kato C, Okuda M. Effect of number of medications and complexity of regimens on medication adherence and blood pressure management in hospitalized patients with hypertension. Plos One. 2021 jun; 16(6): e0252944. Doi: 10.1371/journal.pone.0252944.
Oliveira PC de, Cavalcante LPL, Medeiros M, Melo ENN de, Gonçalves IA de J, Torquato TM, et al. Violência e uso de álcool e outras drogas: percepções e vivências de adolescentes escolares. Ciência, Cuidado E Saúde. 2024 fev; 23:230. Doi: https://doi.org/10.4025/ciencuidsaude.v23i0.65954.
Anderson LJ, Nuckols TK, Coles C, Le MM, Schnipper JL, Shane R, et al. A systematic overview of systematic reviews evaluating medication adherence interventions. American Journal of Health-System Pharmacy. 2020 jan; 77(2): 138-147. Doi: https://doi.org/10.1093/ajhp/zxz284.
Santos DGPML, Silva FP, Guedes TG, Ventura CAA, Silva RA, Frazão IS. Guia da gestão autônoma da medicação como ferramenta educativa do enfermeiro na atenção psicossocial. Enferm Foco. 2023 dez; 14: e-202371. Doi: https://doi.org/10.21675/2357-707X.2023.v14.e-202371.
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