Avaliação da adequação do tratamento farmacológico em relação à gravidade nos pacientes portadores de doença pulmonar obstrutiva Crônica (DPOC) e suas correlações clínicas
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Data
2018-02-28
Autores
Morais, Bruna Evelyn Bueno de
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Universidade Estadual Paulista (Unesp)
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Introdução: A DPOC é uma doença progressiva e que requer tratamento farmacológico para o controle dos sintomas respiratórios. Entretanto, são escassos dados brasileiros que avaliaram o uso de fármacos conforme a gravidade da doença e que verificaram sua adesão ao tratamento da DPOC. Objetivo: Avaliar a adequação, aderência e técnica do tratamento farmacológico pulmonar em relação à gravidade nos pacientes com DPOC. Métodos: Foram avaliados 181 pacientes com DPOC leve a muito grave (47,5 % sexo masculino) com idade: 67,7 ± 9,8 anos e volume expiratório forçado no primeiro segundo (VEF1): 44,6 ± 17,1%. Todos pacientes foram avaliados quanto à adequação farmacológica (GOLD 2017), magnitude da dispneia (Medical ResearchCouncil Modificado – MMRC), Questionário COPD Assessment Test (CAT), frequência de exacerbações no último ano, aderência referida aos fármacos inalatórios e a verificação da técnica dos dispositivos inalatórios. Resultados: Do total de pacientes avaliados, ao separar pela gravidade GOLD, obtivemos GOLD I = 9, GOLD II = 48, GOLD III = 62 e GOLD IV = 62 e ao separar pelos grupos sintomáticos, obtivemos: A = 40, B = 112, C = 5 e D= 24. Em relação à adequação ao tratamento farmacológico pulmonar, 40% do grupo A e 72,5% do grupo B estavam utilizando corticoide inalatório sem história de exacerbações no último ano. Quanto à aderência referida ao tratamento e à técnica do dispositivo inalatório, observamos que a maioria estava aderente (78%) e realizavam a técnica de maneira adequada (64 %). Conclusão: Há utilização de excesso de corticoide inalatório nos pacientes com doença mais leve. Entretanto, a maioria dos pacientes aderem ao tratamento e fazem o uso de dispositivo inalatório corretamente.
Background: COPD is a progressive disease and requires pharmacological treatment to control respiratory symptoms. However, there are few Brazilian data that evaluated the use of pharmacological treatment according to the disease severity or verified their adherence to COPD treatment. Objective: To evaluate the adequacy, adherence and technique of pulmonary pharmacological treatment in relation to severity in COPD patients. Methods: We evaluated 181 patients with mild to very severe COPD (47.5% male) with age: 67.7 ± 9.8 years old and forced expiratory volume in the first second (FEV1): 44.6 ± 17.1%. All patients were evaluated by pharmacological adequacy (GOLD 2017), dyspnea’s magnitude (Medical Research Council Modified - MMRC), COPD Assessment Test (CAT), frequency of exacerbations in the last year, adherence to inhaled pharmacological treatment and technique’s verification devices. Results: We obtained GOLD I = 9, GOLD II = 48, GOLD III = 62 and GOLD IV = 62, and when separated by symptomatic groups, we obtained: A = 40, B = 112, C = 5 and D = 24. Regarding the suitability for pulmonary pharmacological treatment, 40% of group A and 72.5% of group B were using inhaled corticosteroids with no history of exacerbations in the last year. Regarding the adherence to the treatment and technique of the inhaler device, we observed that the majority were adherent (78%) and performed the technique adequately (64%). Conclusion: There is an excess of inhaled corticosteroids in patients with milder disease. However, most patients adhere to treatment and use inhaled device correctly. Key-words: COPD, adherence, adequacy, technique, inhalation device
Background: COPD is a progressive disease and requires pharmacological treatment to control respiratory symptoms. However, there are few Brazilian data that evaluated the use of pharmacological treatment according to the disease severity or verified their adherence to COPD treatment. Objective: To evaluate the adequacy, adherence and technique of pulmonary pharmacological treatment in relation to severity in COPD patients. Methods: We evaluated 181 patients with mild to very severe COPD (47.5% male) with age: 67.7 ± 9.8 years old and forced expiratory volume in the first second (FEV1): 44.6 ± 17.1%. All patients were evaluated by pharmacological adequacy (GOLD 2017), dyspnea’s magnitude (Medical Research Council Modified - MMRC), COPD Assessment Test (CAT), frequency of exacerbations in the last year, adherence to inhaled pharmacological treatment and technique’s verification devices. Results: We obtained GOLD I = 9, GOLD II = 48, GOLD III = 62 and GOLD IV = 62, and when separated by symptomatic groups, we obtained: A = 40, B = 112, C = 5 and D = 24. Regarding the suitability for pulmonary pharmacological treatment, 40% of group A and 72.5% of group B were using inhaled corticosteroids with no history of exacerbations in the last year. Regarding the adherence to the treatment and technique of the inhaler device, we observed that the majority were adherent (78%) and performed the technique adequately (64%). Conclusion: There is an excess of inhaled corticosteroids in patients with milder disease. However, most patients adhere to treatment and use inhaled device correctly. Key-words: COPD, adherence, adequacy, technique, inhalation device
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DPOC, aderência, adequação, técnica, dispositivo inalatório, COPD, adherence, adequacy, technique, inhalation device