Therapeutic Adherence in patients with Vascular Cognitive Impairment, Institue of Neurology, January – April 2024
DOI:
https://doi.org/10.56294/hl2024.351Keywords:
Therapeutic adherence, Vascular Cognitive Impairment, Cerebrovascular DiseaseAbstract
Introduction: Therapeutic adherence is the degree to which a person's behavior in taking their medication corresponds to the agreed recommendations of their doctor. In Vascular Cognitive Impairment characterized by impairment in at least 1 of 4 cognitive domains, slight or no impairment in daily living activities, brain images compatible with Cerebrovascular Disease and temporal relationship between stroke and cognitive symptoms, compliance with the therapeutic regimen is of utmost importance in order to stop its progression to Vascular Dementia. Objective: To characterize therapeutic adherence in patients with Vascular Cognitive Impairment in the outpatient clinic of the Institute of Neurology and Neurosurgery. Methods: An observational, analytical, retrospective, cross-sectional study was carried out in the outpatient clinic of the Institute of Neurology and Neurosurgery in the period from January to April 2024. Demographic and clinical variables were collected, including the application of the Morisky-Green Test. Results: 34.3% of patients were adherent, there was a statistically significant relationship between age and therapeutic adherence, and a relationship was evident with the duration of the disease (p=0.025) and the values of the neuropsychological tests (p=0.000) in relation to non-adherence. Conclusions: In Vascular Cognitive Impairment, the frequency of therapeutic adherence was low. There was no relationship between sex, educational level, monetary income, time of diagnosis and time of initiation of treatment with therapeutic adherence.
References
1. Zeber JE, Manias E, Williams AF, Hutchins D, Udezi WA, Roberts CS et al. A systematic literature review of psychosocial and behavioral factors associated with initial medication adherence: a report of the ISPOR medication adherence & persistence special interest group. Value Health. 2013; 16 (5): 891-900.
2. Mistry N, Keepanasseril A, Wilczynski NL, Nieuwlaat R, Ravall M, Haynes RB et al. Technology-mediated interventions for enhancing medication adherence. Oxford University Press. J Am Med InformAssoc 2015; 22 (e1): e177-193.
3. Teixeira Leite AM, González-Argote J. Exploring the connections between Microbiome and Dementia: systematic review. Salud, Ciencia y Tecnología - Serie de Conferencias [Internet]. 2023 [cited 2025 Jan. 26];2:336. Available from: https://conferencias.ageditor.ar/index.php/sctconf/article/view/285
4. Llibre JJ, Valhuerdi A, Sánchez II, Reyna C, Guerra MA, Copeland JRM, et al. The prevalence, correlates and impact of dementia in Cuba. A 10/66 Group population based survery. Neuroepidemiology 2008; 31: 243- 251 [citado 2012 ene21] Disponible a partir http://content.karger.com/produktedb /produkte.asp?doi= 165362
5. Buergo Zuaznábar MA. Programa nacional de prevención y control de la enfermedad cerebro vascular. Rev cubana Invest Bioméd 2001; 20(4):247-8.
6. Arévalo AM, López GM, López SD, Martínez RF. Adherencia a la terapéutica farmacológica en pacientes con hipertensión arterial. Revista Médica HJCA. 2016; 8 (1): 8-13.
7. Mimenza Aj, Cantú Cg, Román G, Gareri P, Aguilar SG, Ruiz Sandoval JL, et al. Latin American Delphi Consensus on Vascular Cognitive Impairment: Definitions, clinical features, Pathophysiology, prevention and treatment. J Neurol Neurosci.2017; 8(5):224.
8. Gorelick PB, Counts SE, Nyenhuis D. Vascular cognitive impairment and dementia. Biochim Biophys Acta. 2016;1862(5):860-868
9. Concepción O, Zuáznabar M. Guías de práctica clínica Enfermedad Cerebrovascular [Internet]. 1.a ed. Habana Cuba: Ciencias Médicas; 2009. 170p. Disponible en: https://www.researchgate.net/publication/264337816_Guias_de_practica_clinica_Enfermedad_Cerebrovascular
10. Nguyen T, La Caze A, Cottrell N. What are validated self-report adherence scales really measuring? A systematic review. Br J Clin Pharmacol. 2014 Mar;77(3):427-45.
11. Bosch- Bayard RI, Llibre- Rodríguez JJ, Fernández- Seco A, Borrego- Calzadilla C, Carrasco- García M, Zayas- Llerena, et al. Cuba's Strategy for Alzheimer Disease and Dementia Syndromes. MEDICC rev.2016; [Consulado:2017 Julio 14] 18(4):9 -13
12. Barbarino P, CEO. The Global Voice on Dementia. Internet. Geneva: Alzheimer s Disease International;29 May 2017. Statement to the 70 th1. Session of the World Health Assembly. [Consultado 21/08/2017]. Disponible en: http://www.alz.co.uk/ news/ global-plan-on-dementia-adopted-by-who
13. Terrado Almarales OO, González Baños Y, Díaz Hernández D, Valdés Pin L, Alfaro Urquiola M. Adherence to treatment in hypertensive patients at the Medical Clinic 6. Salud, Ciencia y Tecnología - Serie de Conferencias [Internet]. 2023 [cited 2025 Jan. 26];2:497. Available from: https://conferencias.ageditor.ar/index.php/sctconf/article/view/415
14. Paolo LNR, Manotupa C, Luis J, Reyes H, Morales A, Pérez P. Tesis para optar el título de Médico Cirujano.
15. Cabellos Goicochea Clemencia Jovita. Adherencia al tratamiento y calidad de vida en pacientes con Hipertensión arterial que acuden a la consulta de salud en un hospital de ESSALUD de Lima, 2022 n=5 Internet]: Universidad privada Norbert Wiener.
16. Palacios Valdez MM. Factores asociados a la adherencia terapéutica en pacientes con hipertensión arterial del centro de salud Buenos Aires de Villa en el año 2023. Factors associated with therapeutic adherence in patients with hypertension in the patients with arterial hypertension at the Buenos Aires de Villa health center in the year 2023 [Internet]. 24 de septiembre de 2023 [citado 2 de abril de 2024]; Disponible en: https://repositorio.uwiener.edu.pe/handle/20.500.13053/9885
17. Ramírez S de la CO, Almeida CV, Vega RC. Adherencia terapéutica en pacientes hipertensos o diabéticos ingresados en el Hospital Clínico Quirúrgico Joaquín Albarrán. Progaleno. 7 de julio de 2020;3(2):66-75
18. Rodríguez T, Malvezzi M, Chatenoud L, C Bosetti, F Levi, E Negri, C La Vecchia. Trends in mortality from coronary heart and cerebrovascular diseases in the Americas: 2010 - 2014. Heart. 2015;9(2):453-60.
19. Consejo Argentino de Hipertensión Arterial. Consenso de hipertensión arterial. Rev Argentina de Cardiología [Internet]. 2013;81(2):1-74. Acceso: 14/06/2020. Disponible en: http://www.sac.org.ar/wpcontent/uploads/2014/04/Consenso-de-Hipertension-Arterial.pdf
20. Pincay Cañarte M. Adherencia al tratamiento de la hipertensión arterial | Revista Científica Higía de la Salud. 24 de febrero de 2022 [citado 15 de abril de 2024];2(1). Disponible en: https://revistas.itsup.edu.ec/index.php/Higia/article/view/531
21. Koh JJK, Cheng RX, Yap Y, Haldane V, Tan YG, Teo KWQ, et al. Access and adherence to medications for the primary and secondary prevention of atherosclerotic cardiovascular disease in Singapore: a qualitative study. PPA. noviembre de 2018; Volume 12:2481-98.
22. Dalal JJ, Kerkar P, Guha S, Dasbiswas A, Sawhney JPS, Natarajan S, et al. Therapeutic adherence in hypertension: Current evidence and expert opinion from India. Indian Heart J. noviembre de 2021;73(6):667-73.
23. Pérez Díez C. Estimación de la adherencia terapéutica de una población rural, anciana y polimedicada. Atalaya Médica Turolense. 2021;(20):7-11.
24. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. DOI: 10.1016/S0140-6736(20)30367-6
25. Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang JG, Sukonthasarn A, et al. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. J Clin Hypertens (Greenwich). marzo de 2021;23(3):513-21.
26. Webb AJS, Werring DJ. New Insights Into Cerebrovascular Pathophysiology and Hypertension. Stroke. abril de 2022;53(4):1054-64.
27. Ray A, Ray TG, Pal J, Ray BK, Sanyal D, Dubey S. Adherence to anti-hypertensive medications and its determinants: A study among hypertensive stroke patients in a tertiary care government hospital of West Bengal. Indian J Public Health. 2021;65(2):198-202.
28. Cruz AP, Rivero BS, Clausell AB, Jorge MC. La enfermedad cerebrovascular y sus factores de riesgo. Rev Cub Med Mil [Internet]. 2020 [citado 22 de abril de 2024];49(3). Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=101993
29. Muñoz-Pérez MJ, Espinosa-Villaseñor D. Deterioro cognitivo y demencia de origen vascular. Rev Mex Neuroci. 2016;17(6):8596.
30. Cuevas H. Assessment of Cognitive Function in Type 2 Diabetes. J Nurse Pract. 2017;13(7);311-15.
31. Schmid H, Hartmann B, Schiffl H. Adherence to prescribed oral medication in adult patients undergoing chronic hemodialysis: a critical review of the literature. Eur J Med Res. 2009;14(5):185-90.
Published
Issue
Section
License
Copyright (c) 2024 Virgen Kirenia Armenteros Iznaga, Javier Vicente Sánchez López, Arianne Rodríguez Velasco, Emmanuel Zayas Fundora (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.