Resumen La farmacoterapia es importante para reestablecer la salud de los adultos mayores, sin embargo, algunos factores propios de este grupo etario pueden dificultar su cumplimiento. El objetivo del estudio fue determinar la adherencia farmacoterapéutica en pacientes del servicio de Geriatría del Hospital Santa Bárbara. Se realizó un estudio analítico transversal de prevalencia en 50 pacientes geriátricos: 33 pacientes hospitalizados y 17 pacientes ambulatorios de consulta externa. Se aplicó un cuestionario diseñado por secciones para las variables sociodemográficas y el Test de Morisky-Green-Levine para valorar la Adherencia farmacoterapéutica. Se construyó una base de datos en Excel, luego del análisis descriptivo de las variables de estudio, se calcularon las medidas de asociación (Odds Ratio) con el programa Epidat. Entre los resultados, se encontró adherencia farmacoterapéutica sólo en el 39 % de pacientes hospitalizados y en el 47% de pacientes de consulta externa. Se observó no adherencia en pacientes comprendidos entre 60 a 79 años de edad, mayor prevalencia en mujeres que en varones; se observó también que a mayor nivel de escolaridad la no adherencia fue mayor; asimismo, la presencia de patología crónica (Diabetes Mellitus, Hipertensión Arterial, etc.), así como la polifarmacia, y el no contar con apoyo familiar aumentó la probabilidad de no adherencia; un porcentaje destacado de pacientes de consulta externa manifestó haber recibido información sobre la medicación por parte del personal médico, farmacéutico y de enfermería del mencionado nosocomio. Este estudio sobre la adherencia farmacoterapéutica en los pacientes geriátricos realizado en el Hospital Santa Bárbara muestra la necesidad de diseñar estrategias en base a los factores de riesgo identificados para mejorar el cumplimiento en beneficio de la salud de dicha población.

Abstract Pharmacotherapy is important to restore the health of older adults, however, some factors of this age group can difficult their achievement. The objective of this study was to determine the pharmacotherapeutic adherence in patients of the Geriatric service at the Santa Bárbara Hospital. A cross-sectional prevalence analysis was conducted in 50 geriatric patients: 33 hospitalized patients and 17 outpatients. A questionnaire designed by sections was applied for sociodemographic variables and the Morisky-Green-Levine test to assess pharmacotherapeutic adherence. A database was constructed in Excel, after the descriptive analysis of the study variables, the association measures (Odds Ratio) were calculated with the Epidat program. Among the results, pharmacotherapeutic adherence was found only in 39% of hospitalized patients and 47% of outpatients. Non-adherence was observed in patients between 60 to 79 years of age, being higher in women than in men; It was also observed that the a higher schooling level, is also related with a higher non-adherence ; likewise, the presence of chronic pathologies (Diabetes Mellitus, Arterial Hypertension, etc.), as well as polypharmacy, and the lack of family support increased the probability of non-adherence. An important percentage of outpatients reported having received information about the medication from the medical, pharmaceutical and nursing staff of the aforementioned hospital. This study on pharmacotherapeutic adherence in geriatric patients performed at the Hospital Santa Bárbara showed the need to design strategies based on the identified risk factors to improve compliance in benefit of the health of older adults.

INTRODUÇÃO: Apresentamos nossa experiência no estudo REMCLI-ATC (REutilización de Materiales no hospital das CLInicas-ATC), que foi desenvolvido no Setor de Hemodinâmica do Departamento de Cardiologia do Hospital de Clínicas da Faculdade de Medicina de Montevidéu, Uruguai, entre setembro de 2001 e agosto de 2002 e entre janeiro de 2003 e dezembro de 2004. MÉTODO: Foram incluídos, prospectivamente, 100 pacientes submetidos a angioplastia transluminal coronária (ATC), nos quais se utilizou aleatoriamente material novo (grupo 1, n = 49) ou reesterilizado (grupo 2, n = 51), analisando-se uma série de variáveis que avaliaram a eficácia e a segurança de cada um dos grupos. RESULTADOS: O sucesso clínico e angiográfico no grupo 1 foi de 100% e no grupo 2, de 96% (p = 0,54). Não foram observadas diferenças em relação ao número de cateteres-guia, guias e balões utilizados na ATC entre os grupos. O volume de contraste e os tempos de radioscopia e do procedimento também não apresentaram diferenças. As complicações maiores ocorreram somente no grupo 2 (0% vs. 3,9%; p = 0,17) e as menores ocorreram em ambos os grupos (6,1% e 9,8%, respectivamente; p = 0,48). CONCLUSÃO: Concluímos, portanto, que é tecnicamente factível e seguro utilizar material reesterilizado nas ATCs, o que permitiria, uma economia considerável para países como o Uruguai, com recursos econômicos limitados.

BACKGROUND: We describe our experience in the REMCLI-ATC (REutilización de Materiales no hospital das CLInicas-ATC) study, which was developed at the Hemodynamics Section of the Department of Cardiology of the Hospital de Clínicas of the Medicine School of Montevideo, Uruguay, from September 2001 to August 2002 and from January 2003 to December 2004. METHODS: A hundred patients were prospectively included and treated with Percutaneous Transluminal Coronary Angioplasty (PTCA) with new (group 1, n = 49) or reprocessed (group 2, n = 51) material. Both groups were evaluated through variables that tested safety and efficacy of each strategy. RESULTS: The clinical and angiographic success rate was 96% with reprocessed material and 100% with new material (p = 0.54). No significant differences were found between the groups regarding the number of guide catheters, guides and balloons used in the PTCA. The volume of contrast medium, radioscopy times and procedure times were also similar. Major complications were seen only in group 2 (0% vs. 3.9%, p = 0.17), while minor complications occurred in both groups (6.1% and 9.8%, respectively; p = 0.48). CONCLUSION: Our data showed that it is technically possible and also safe to treat patients using reprocessed material in PTCA procedures. Theoretically this would result in an important resource saving in economically limited countries like Uruguay.