[Adherence to drug treatment among registered users in the "HIPERDIA" Program in Teresina in the State of Piauí]

Melatonin and Cytokines Modulate Daily Instrumental Activities of Elderly People with SARS-CoV-2 Infection

The Comprehensive Geriatric Assessment analyzes the health and quality of life of the elderly. Basic and instrumental daily activities may be compromised due to neuroimmunoendocrine changes, and studies suggest that possible immunological changes occur during infections in the elderly. Thus, this study aimed to analyze cytokine and melatonin levels in serum and correlate the Comprehensive Geriatric Assessment in elderly patients with SARS-CoV-2 infection. The sample consisted of 73 elderly individuals, 43 of whom were without infection and 30 of whom had positive diagnoses of COVID-19. Blood samples were collected to quantify cytokines by flow cytometry and melatonin by ELISA. In addition, structured and validated questionnaires were applied to assess basic (Katz) and instrumental (Lawton and Brody) activities. There was an increase in IL-6, IL-17, and melatonin in the group of elderly individuals with infection. In addition, a positive correlation was observed between melatonin and IL-6 and IL-17 in elderly patients with SARS-CoV-2 infection. Furthermore, there was a reduction in the score of the Lawton and Brody Scale in the infected elderly. These data suggest that the melatonin hormone and inflammatory cytokines are altered in the serum of the elderly with SARS-CoV-2 infection. In addition, there is a degree of dependence, mainly regarding the performance of daily instrumental activities, in the elderly. The considerable impact on the elderly person's ability to perform everyday tasks necessary for independent living is an extremely important result, and changes in cytokines and melatonin probably are associated with alterations in these daily activities of the elderly.

Factors associated with adherence to pharmacological treatment in hypertensive patients enrolled in the HIPERDIA program

Objective: To assess adherence to antihypertensive treatment in patients at a Family Health Strategy (FHS) unit. Methods: quantitative, transversal, and observational study with 131 hypertensive patients registered in the HIPERDIA program of an FHS located in the city of Lagarto, Sergipe, Brazil, through the analysis of medical records and the application of structured questionnaires. The assessment of the degree of adherence was carried out through the Brief Medication Questionnaire. Results: Factors related to poor adherence were illiteracy (PR: 0.61; 95%CI: 0.42 - 0.89), per capita family income < 1 minimum wage (PR: 0.51; 95%CI : 0.33 - 0.78) and high pharmacological complexity (PR: 0.66; 95%CI: 0.45 - 0.97), while only regular physical activity (PR: 2.64; 95%CI: 1.28 - 5.46) and a good quality of life (PR: 1.44; 95%CI: 1.02 - 2.04) remained positively associated with adherence. Conclusion: As these are modifiable factors, the simplification of the therapeutic scheme and the regular practice of physical activity are key points for increasing adherence to the treatment of systemic arterial hypertension in Primary Care.

Trends in the prevalence of systemic arterial hypertension and health care service use in Brazil over a decade (2008-2019)

The global burden and the prevalence of systemic arterial hypertension (SAH) have increased over the last two decades, especially in low- and middle-income countries, and are a concern to health authorities. This study analyzed the prevalence of SAH reported by Brazilian adults in 2008, 2013, and 2019, and individual disease control in 2013 and 2019. Data from the National Household Sample Survey (2008) and National Health Survey (2013-2019) were employed. We calculated the disease's prevalence ratios using Poisson regression, adjusted for sociodemographic characteristics. Regarding health care and PHC organization indicators, we calculated proportions by gender, age group, ethnicity, and region. The results reveal persistent regional inequalities, with lower prevalence in the North and Northeast and higher prevalence in the Southeast and South. While the health care access and use indicators are positive, reflecting PHC improvements in recent years, we highlight the importance of adopting multifaceted SAH prevention and control strategies in the country.

Medication Adherence In Patients With Arterial Hypertension: The Relationship With Healthcare Systems' Organizational Factors

PURPOSE

Arterial hypertension is one of the most common diseases in the world, presenting a great impact on global mortality. Despite having good medication, the best control depends on patient's adherence. Our aim is to characterize the relationship of adherence to medication in hypertensive patients with consultation length and other organizational factors of healthcare systems.

PATIENTS AND METHODS

We performed a comprehensive review of literature using the MeSH terms "hypertension" and "medication adherence". 61 articles were selected for inclusion and adherence parameters were extracted, allowing us to estimate the mean adherence for each country. The adherence was then correlated with organizational aspects of healthcare systems: consultation length, number of health providers (doctors, nurses and pharmacists), number of hospital beds, health expenditure and general government expenditure.

RESULTS

Adherence to medication ranged between 11.8% in Indonesia and 85.0% in Australia. There is much heterogeneity in methodology, but the Morisky Medication Adherence Scale was the preferred method, used in 63.6% of the cases. We found no relation with consultation length, but a significant one with the greater number of health professionals available. Some differences were observed when considering European countries or Morisky Medication Adherence Scale alone.

CONCLUSION

The better the drugs, the better the control of blood pressure, if patients take them. Rather than investing in the prescription of more drugs, it is important to address non-adherence and reduce it to promote better blood pressure control. Organizational factors are relevant constraints and depend on administrative and political decisions. Although they are not always considered, they greatly impact the adherence to medication.

Social networks and health practices: influence of a diabetes online community on adherence to treatment

This study aims to understand how online communities can contribute to increasing the adherence of chronic patients to the treatment prescribed by the physician in Brazil. For this purpose, we applied the netnography method to analyze the community Diabetes: vivendo e aprendendo - troca de informações (free translation: "Diabetes: living and learning - information exchange"), considering the dimensions of adherence proposed by the World Health Organization (WHO) as a theoretical framework. The analysis shows the influence of cyberculture on health and disease processes, resulting in changes in physician-patient relationships, patient empowerment, and individual management of own chronic condition. The results also showed a positive influence of the interactions established in the community on the multidimensional factors of the adherence model proposed by the WHO1, also leading to the possibility of including a sixth related to connectivity. The primary motivations identified for community participation were access to information on the disease and treatment, the sharing of experiences and social support. Thus, the proposition of health policies that help chronic patients meet these needs tends to contribute to increased adherence to treatment.

Association between follow-up in health services and antihypertensive medication adherence

OBJECTIVE

To analyze the association between the characteristics of follow-up in health services and adherence to antihypertensive medication in patients with cardiovascular disease.

METHOD

Analytical study carried out with 270 patients suffering from hypertension and hospitalized due to cardiovascular complications. Data collection occurred between November 2015 and April 2016, involving sociodemographic variables, presence of self-reported diabetes, accessibility and use of health services, blood pressure levels and medication adherence (analyzed through the Morisky-Green Test).

RESULTS

The rate of adherence to antihypertensive therapy was 63.0%. Enrollment in the Hiperdia program had no statistical significance to medication adherence. People who attended at least between 4 and 6 nursing consultations throughout the data collection period (p = 0.02) had better adherence.

CONCLUSION

The study's findings provide support for the reorientation of health services and their public policies towards improving adherence to antihypertensive therapeutics.

Access and adherence to medication among people with diabetes in Brazil: evidences from PNAUM

OBJECTIVE

To describe people with diabetes in Brazil and to compare their sociodemographic characteristics, access and self-reported adherence to diabetes prescribed drugs.

METHODS

Data analysis from the National Survey on Access, Use and Promotion of the Rational Use of Medicines, a household survey, with sampling by clusters, according to sex and age domains and national and macro-regional representativeness. Adults (≥ 20 years old) who reported having diabetes constituted the sample. The weighted frequencies of the variables in the sample were analyzed and the Pearson χ2 test was applied to evaluate the statistical significance of the differences between the strata for the data of access, form of financing and adherence to the drugs, considering the level of significance of 5%.

RESULTS

We found a higher proportion of women, people over 60 years and economy class C. Most participants reported having two or more comorbidities, in addition to diabetes, and taking five or more drugs. Regarding access, 97.8% say they have access to prescription drugs for diabetes and 70.7% say they get them totally free of charge. There was low adherence to anti-diabetic treatment, with significant macro-regional differences (p = 0,001), and greater vulnerability in the South and Northeast regions.

CONCLUSION

Better access to diabetes medicines in the country has been demonstrated. However, to improve the efficiency of health public spending, it is necessary to achieve higher rates of adherence to treatment.

Medication use by the elderly: analysis of prescribing, dispensing, and use in a medium-sized city in the state of São Paulo

Abstract Objective: To describe the prescribing, dispensing, use, adhesion, and storage of medicines to and by the elderly. Method: A descriptive cross-sectional study was performed in Estratégia Saúde da Família (Family Health Strategy) health centers (ESF), in Marília in the state of São Paulo, Brazil, based on the records of and interviews with 114 individuals seven to ten days after a medical consultation. A descriptive analysis was carried out. Results: The mean number of prescribed drugs was 4.98 per elderly patient. Of the total number of prescribed drugs, 81.5% were supplied by public services, with the nutrient (50%); antilipemic (62.1%); analgesic (30.7%); dermo-protector (66.6%); herbal (40%) and parasite and antifungal (37.5%) classes dispensed the least. A total of 83.8% of the prescribed drugs were used, while the drugs dispensed at the lowest rates were not used by the elderly, except for analgesics. A total of 40.3% of the respondents exhibited low adherence. Most stored their medicines in a suitable place. Conclusion: The prescribing, dispensing, use and storage of medications to and by the elderly can be considered effective, but adherence remains low, requiring new strategies and interventions.

[Analysis of three health education strategies for patients with arterial hypertension]

The scope of this article is to compare the effect of three health and nutrition education strategies on adherence to the non-pharmacological treatment of systemic arterial hypertension (SAH), using anthropometric, biochemical, clinical and dietetic parameters. It is a longitudinal intervention study of the comparative and quantitative approach community test. The sample was comprised of 212 individuals diagnosed with SAH, who met the inclusion/exclusion criteria. Participants were allocated into three groups, in order to evaluate different methods of intervention, carried out on a monthly basis, for twelve months. The Kolmogorov-Smirnov, ANOVA and Kruskal-Wallis tests were performed for the analyses. Educational interventions in Group 1 and 2 provided the best results on adherence to the non-pharmacological treatment of SAH. In the comparative analysis of different groups, the reduction of glucose showed statistical significant difference, with Group 2 showing the best evolution. Group 1 and 2 had better results on adherence to non-pharmacological treatment of SAH. It is important to stress that in health service practices there is a challenge to promote health education able to intervene on the issue of adherence to the treatment of SAH.

Functional health literacy and adherence to the medication in older adults: integrative review

Objective:

to characterize the national and international scientific production on the relationship of Functional Health Literacy and the adherence to the medication in older adults.

Method:

integrative review of literature, searching the following online databases: Scientific Electronic Library Online (SCIELO); Latin American and Caribbean Health Sciences Literature (LILACS); Medical Literature Analysis and Retrieval System Online (MEDLINE); and Cumulative Index to Nursing & Allied Health Literature (CINAHL), in June 2016. We selected 7 articles that obeyed the inclusion criteria.

Results:

all articles are from the USA. The inappropriate Functional Health Literacy affects the non-adherence to medication; however, there are several strategies and interventions that can be practiced to change this relationship.

Conclusion:

nursing needs to explorefurther this theme, since it can exert a differentiated care for adherence to medication in older adults, considering the literacy.

Objetivo:

caracterizar a produção científica nacional e internacional sobre a relação do Letramento Funcional em Saúde e a adesão à medicação em idosos.

Método:

revisão integrativa da literatura, com busca nas bases de dados on-line: Scientific Electronic Library Online (SCIELO); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Medical Literature Analysis and Retrieval System Online (MEDLINE); e Cumulative Index to Nursing & Allied Health Literature (CINAHL), no mês de junho de 2016. Foram selecionados 7 artigos que obedeceram aos critérios de inclusão.

Resultados:

todos os artigos são internacionais e originários dos EUA. O Letramento Funcional em Saúde inadequado influencia para a não adesão à medicação, porém há diversas estratégias e intervenções que podem ser realizadas na prática para modificar essa relação.

Conclusão:

a enfermagem precisa explorar mais essa temática, visto que pode exercer um cuidado diferenciado para a adesão à medicação em idosos, levando em conta o letramento.

Knowledge about hypertension and factors associated with the non-adherence to drug therapy

OBJECTIVES

to identify the degree of knowledge of people with hypertension concerning the disease and to verify the factors associated with the non-adherence to anti-hypertensive drug therapy.

METHOD

Cross sectional study, involving 422 people. Data collection took place at their homes, between December 2011 and March 2012, through interviews using the following instruments: Medication Adherence Questionnaire (MAQ-Q), Medication Regimen Complexity Index (MRCI) and a guide with questions related to sociodemographic profile, satisfaction with healthcare service and knowledge about the disease.

RESULTS

42.6% did not adhere to the drug therapy and 17.7% had poor knowledge about the disease. Factors associated with the non-adherence were: complex drug therapy, poor knowledge about the disease and dissatisfaction with the healthcare service.

CONCLUSION

The findings reinforce that the complex drug therapy prescriptions, little knowledge about the disease and dissatisfaction with the healthcare service have influence on the process of non-adherence to anti-hypertensive drug therapy.

Adherence to non-pharmacological treatment: Analysis of the impact of three health educational and nutritional strategies in hypertensive patients

ABSTRACT Objective: To evaluate adherence to non-pharmacological treatment of hypertension by comparing biochemical, clinical, anthropometric, and dietary parameters before and after three health educational and nutritional strategies. Methods: This longitudinal clinical trial included 212 hypertensive individuals who met the inclusion criteria. The participants were allocated to three groups to assess the impact of monthly intervention methods over twelve months. Results: Waist circumference decreased significantly in all groups. Weight and body mass index decreased significantly in Groups 2 and 3. Blood glucose, total cholesterol, and low-density lipoprotein cholesterol decreased significantly in Groups 1 and 2. The interventions also reduced the mean per capita intakes of oil, sugar, and salt in all groups. Conclusion: Educational interventions promoted adherence to non-pharmacological treatment of treatment of hypertension evidenced by anthropometric (weight, body mass index, and waist circumference), biochemical (blood glucose, total cholesterol, and low-density lipoprotein cholesterol), and dietary (meanper capita intake of oil, sugar, and salt) parameters.

ELDERLY RECEIVING OUTPATIENT CARE: REASONS FOR ADHERENCE/NONADHERENCE TO MEDICATION

ABSTRACT This study aimed to characterize the elderly receiving outpatient care in Rio Grande, Rio Grande do Sul state, Brazil, concerning their demographic and socioeconomic characteristics, health condition, medication usage and adherence to medication; to identify their self-reported reasons for adherence/nonadherence to the prescribed medication. A descriptive, cross-sectional study, with a quantitative approach, performed in the outpatient unit of a university hospital in Rio Grande do Sul, Brazil. One hundred seven elderly were interviewed in November of 2013. Data were collected with three instruments. The statistical analysis was descriptive. Among the elderly, 86.9% were adherent to medication. Wanting to feel good was the reason most often reported for adherence to the prescribed medication, and the occurrence of adverse reactions was the most often cited reason for nonadherence. The results of this study can support the development of actions that promote adherence to medication by the elderly.

Fatores associados a não adesão medicamentosa entre idosos de um ambulatório filantrópico do Espírito Santo

OBJETIVOS: Estimar a frequência da não adesão ao tratamento medicamentoso entre idosos acompanhados ambulatorialmente, bem como analisar seus fatores associados. METODOLOGIA: Foi conduzido estudo transversal com 263 idosos atendidos no ambulatório de especialidades médicas de um hospital filantrópico, localizado no município de Vitória-ES. Foi realizada entrevista utilizando roteiro estruturado em três blocos que contemplavam questões sociodemográficas, condições de saúde e estilo de vida e medicamentos em uso. Para verificar a não adesão ao tratamento medicamentoso, foi aplicado o instrumento de Medida de Adesão Terapêutica (MAT). Os dados foram analisados por meio do teste Qui-quadrado para variáveis categóricas. Foram consideradas significativas as variáveis com valor de p<0,05 no modelo final de regressão múltipla de Poisson. RESULTADOS: Os resultados mostraram uma frequência de não adesão ao tratamento medicamentoso de 26,7% da amostra. A não adesão ao tratamento medicamentoso nessa população se mostrou positivamente associada à ausência de vínculo empregatício anterior a aposentadoria (RP=1,12; p<0,010); presença de declínio cognitivo (RP=1,13; p<0,010) e hábitos alimentares inadequados (RP=1,12; p<0,005). CONCLUSÃO: Com o estudo, foi possível identificar os fatores associados à não adesão medicamentosa nos idosos investigados e assim contribuir para o conhecimento do perfil sociodemográfico, condições de saúde e estilo de vida e características relacionadas à utilização de medicamentos por parte dessa população.

Elaboration and validation of instrument to assess adherence to hypertension treatment

OBJECTIVE

To elaborate and validate an instrument of adherence to treatment for systemic arterial hypertension, based on Item Response Theory.

METHODS

The process of developing this instrument involved theoretical, empirical and analytical procedures. The theoretical procedures included defining the construct of adherence to systemic arterial hypertension treatment, identifying areas involved and preparing the instrument. The instrument underwent semantic and conceptual analysis by experts. The empirical procedure involved the application of the instrument to 1,000 users with systemic arterial hypertension treated at a referral center in Fortaleza, CE, Northeastern Brazil, in 2012.. The analytical phase validated the instrument through psychometric analysis and statistical procedures. The Item Response Theory model used in the analysis was the Samejima Gradual Response model.

RESULTS

Twelve of the 23 items of the original instrument were calibrated and remained in the final version. Cronbach’s alpha coefficient (α) was 0.81. Items related to the use of medication when presenting symptoms and the use of fat showed good performance as they were more capable of discriminating individuals who adhered to treatment. To ever stop taking the medication and the consumption of white meat showed less power of discrimination. Items related to physical exercise and routinely following the non-pharmacological treatment had most difficulty to respond. The instrument was more suitable for measuring low adherence to hypertension treatment than high.

CONCLUSIONS

The instrument proved to be an adequate tool to assess adherence to treatment for systemic arterial hypertension since it manages to differentiate individuals with high from those with low adherence. Its use could facilitate the identification and verification of compliance to prescribed therapy, besides allowing the establishment of goals to be achieved.

Comparative analysis of non-adherence to medication treatment for systemic arterial hypertension in urban and rural populations

OBJECTIVE

to evaluate the indexes and the main factors associated with non-adherence to medication treatment for systemic arterial hypertension between urban and rural areas.

METHOD

analytical study based on an epidemiological survey with a sample of 247 hypertensive residents of rural and urban areas, with application of a socio-demographic and economic questionnaire, and treatment adherence assessment. The Pearson's Chi-square test was used and the odds ratio (OD) was calculated to analyze the factors related to non-adherence.

RESULTS

the prevalence of non-adherence was 61.9% and it was higher in urban areas (63.4%). Factors significantly associated with non-adherence were: male gender (OR=1.95; 95% CI 1.08-3.50), age 20-59 years old (OR=2.51; 95% CI 1.44-4.39), low economic status (OR=1.95; 95% CI 1.09-3.47), alcohol consumption (OR=5.92, 95% CI 1.73-20.21), short time of hypertension diagnosis (OR=3.07; 95% CI 1.35-6.96) and not attending the health service for routine consultations (OR=2.45; 1.35-4.42).

CONCLUSION

the socio-demographic/economic characteristics, lifestyle habits and how to relate to health services were the factors that presented association with non-adherence regardless of the place of residence.

Avaliação do risco coronariano e sua relação com as ações de saúde em hipertensos

Avaliou-se o risco para desenvolvimento de eventos coronarianos agudos de acordo com os critérios de Framingham e com as ações de saúde realizadas em hipertensos de uma Unidade de Saúde da Família de Vitória-ES. Estudo observacional, de corte transversal, envolvendo 330 hipertensos. A amostra considerou prevalência do agravo de 50%. Os dados foram coletados dos prontuários e as variáveis constituíram o risco coronariano, a pressão arterial, o número de consultas, de atividades educativas e de medicamentos prescritos. Foi utilizada a ANOVA para comparar as variáveis e o teste t pareado para comparação da pressão no período estudado, com nível de significância de 5%. Respectivamente, 115 (34,8%) sujeitos apresentaram baixo risco de infarto ou morte por doença coronariana nos próximos 10 anos; 67 (20,4%) apresentaram médio risco; e 148 (44,8%) apresentaram alto risco. Somente o quantitativo de medicamentos prescritos mostrou relação significante com o risco coronariano elevado.

The 8-item Morisky Medication Adherence Scale: validation of a Brazilian-Portuguese version in hypertensive adults

BACKGROUND

The Morisky Medication Adherence Scale (MMAS-8) remains one of the most widely used mechanisms to assess patient adherence. Its translation and testing on languages in addition to English would be very useful in research and in practice.

OBJECTIVE

To translate and examine the psychometric properties of the Portuguese version of the structured self-report eight-item Morisky Medication Adherence Scale among patients with hypertension.

METHODS

The study was designed as a cross-sectional survey conducted in six Family Health Units of the Brazilian Unified Health System, in Maceió, between March 2011 and April 2012. After a standard "forward-backward" procedure to translate MMAS-8 into Portuguese, the questionnaire was applied to 937 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach's alpha), and test-retest reliability. Validity was confirmed using known groups validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high).

RESULTS

The mean age of respondents was 57.1 years (SD = 12.7 years), and 71.5% were female. The mean number of prescribed antihypertensives per patient was 1.62 (SD = 0.67). The mean score for the medication adherence scale was 5.78 (SD = 1.88). Moderate internal consistency was found (Cronbach's alpha = 0.682), and test-retest reliability was satisfactory (Spearman's r = 0.928; P < 0.001). A significant relationship between MMAS-8 levels of adherence and BP control (chi-square, 8.281; P = 0.016) was found. 46.0%, 33.6%, and 20.4% of patients had low, medium, and high adherence, respectively. The self-report measure sensitivity, specificity, positive and negative predictive values were 86.1%, 31.2%, 57.4% and 68.3% respectively.

CONCLUSIONS

Psychometric evaluation of the Portuguese version of the MMAS-8 indicates that it is a reliable and valid measure to detect patients at risk of non-adherence. The MMAS-8 could still be used in routine care to support communication about the medication-taking behavior in hypertensive patients.

Prevalence of thyroid dysfunction in patients with diabetes mellitus

BACKGROUND

Diabetes mellitus (DM) and thyroid dysfunction (TD) are the two most common endocrine disorders in clinical practice. The unrecognized TD may adversely affect the metabolic control and add more risk to an already predisposing scenario for cardiovascular diseases. The objective of this study was to investigate the prevalence of TD in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM).

METHODS

This is an observational cross-sectional study. Three hundred eighty-six (386) patients with T1DM or T2DM that regularly attended the outpatient clinic of the Diabetes unit, Hospital Universitário Pedro Ernesto, participated in the study. All patients underwent a clinical and laboratory evaluation. Thyroid dysfunction was classified as clinical hypothyroidism (C-Hypo) if TSH > 4.20 μUI/mL and FT4 < 0.93 ng/dL; Subclinical hypothyroidism (SC-Hypo) if TSH > 4.20 μUI/ml and FT4 ranged from 0.93 to 1.7 ng/dL; Subclinical hyperthyroidism (SC-Hyper) if TSH < 0.27 μUI/ml and FT4 in the normal range (0.93 and 1.7 ng/dL) and Clinical hyperthyroidism (C-Hyper) if TSH < 0.27 μUI/ml and FT4 > 1.7 μUI/mL. Autoimmunity were diagnosed when anti-TPO levels were greater than 34 IU/mL. The positive autoimmunity was not considered as a criterion of thyroid dysfunction.

RESULTS

The prevalence of TD in all diabetic patients was 14,7%. In patients who had not or denied prior TD the frequency of TD was 13%. The most frequently TD was subclinical hypothyroidism, in 13% of patients with T1DM and in 12% of patients with T2DM. The prevalence of anti-TPO antibodies was 10.8%. Forty-four (11.2%) new cases of TD were diagnosed during the clinical evaluation. The forty-nine patients with prior TD, 50% with T1DM and 76% with T2DM were with normal TSH levels.

CONCLUSIONS

We conclude that screening for thyroid disease among patients with diabetes mellitus should be routinely performed considering the prevalence of new cases diagnosed and the possible aggravation the classical risk factors such as hypertension and dyslipidemia, arising from an undiagnosed thyroid dysfunction.

Adesão à medicação em pacientes com doença de Parkinson atendidos em ambulatório especializado

A doença de Parkinson é universal, sendo a segunda doença neurodegenerativa mais comum em idosos e tem alta prevalência, afetando entre 0,5 e 1% da população com idade entre 65 e 69 anos. A adesão à terapia medicamentosa é considerada o principal determinante para a efetividade do tratamento, porém apenas recentemente vem sendo estudado em pacientes com doença de Parkinson. Trata-se de estudo transversal e descritivo que avaliou a adesão à terapia com levodopa em 112 pacientes com doença de Parkinson que frequentavam regularmente o ambulatório de distúrbios do movimento do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo utilizando o teste Morisky e Green e o instrumento que avalia atitudes frente à tomada dos remédios (IAAFTR). Dos pacientes entrevistados, 53% não apresentaram adesão ao tratamento e 52% não tomam a medicação no horário correto. Os pacientes devem ser orientados sobre a importância de ingerir sua medicação no horário correto, entendendo os benefícios que a adesão pode proporcionar estando cientes de que doses não tomadas, tomadas em excesso, ou em horários diferentes dos prescritos podem diminuir sua resposta ao tratamento, afetando negativamente sua evolução clínica e qualidade de vida, gerando maiores custos à saúde pública do país.