Association between polypharmacy, medication adherence, and quality of life in patients with chronic kidney disease: a preliminary study in the Brazilian Amazon
DOI:
https://doi.org/10.15343/0104-7809.202549e17452025PKeywords:
Chronic Kidney Disease, Treatment Adherence, Quality of LifeAbstract
Chronic kidney disease (CKD) is a progressive condition that requires complex pharmacological management, with polypharmacy being highly prevalent and potentially compromising treatment adherence and quality of life. This cross-sectional study included 52 patients with CKD treated at a regional hospital in northern Brazil. Its objective was to examine the association between polypharmacy, treatment adherence, and quality of life. Adherence was assessed using the Morisky-Green Test, while quality of life was measured with the abbreviated version of the WHOQOL-BREF instrument. Results demonstrated that 65% of patients presented moderate adherence, while 35% exhibited low adherence, which was significantly associated with lower quality-of-life scores, particularly in the physical and psychological domains. Female sex, higher educational level, and recent diagnosis (1–3 years) were predictors of better adherence. Statistical analyses included chi-square tests and logistic regression, with a 5% significance level and adjustments for sociodemographic variables. These findings reinforce the negative impact of low adherence to pharmacotherapy on the quality of life of patients with CKD and highlight the importance of targeted interventions, including individualized pharmacotherapy review, health education programs, and psychosocial support, to improve adherence and promote patient well-being.
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This article is a translation in Português (Brasil) of the article:
Association between polypharmacy, medication adherence, and quality of life in patients with chronic kidney disease: a preliminary study in the Brazilian Amazon
References
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Almeida ED, Rodrigues LCS, Vieira JLF. Estimates of adherence to treatment of vivax malaria. Malar J.2014;13:321. doi:10.1186/1475-2875- 13-321.
World Health Organization (WHO). WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment. Geneva: WHO; 1996.
Marinho CLA, Oliveira JF, Borges JES, Silva RS, Fernandes FECV. Qualidade de vida de pessoas com doença renal crônica em hemodiálise. Rev Rene. 2017;18:396-403. Disponível em: https://www.redalyc.org/journal/3240/324053754016/html/.
Mattos M, Maruyama SAT. A experiência de uma pessoa com doença renal crônica em hemodiálise. Rev Gaucha Enferm. 2010;31(3):428- 34. doi:10.1590/S1983-14472010000300004.
Ottaviani AC, Bettoni LC, Paravini SCI, Say KG, Zazzetta MS, Orlandi FS. Associação entre ansiedade e depressão e a qualidade de vida de pacientes renais crônicos em hemodiálise. Texto Contexto Enferm.2016;25:e00650015. Disponível em: https://www.scielo.br/j/tce/ a/6QmQ3c5mQKcV9zXb6bK9W3z/.
Silva GD, Fernandes BD, Silva FA, Dias YCB, Melchiors AC. Qualidade de vida de pacientes com insuficiência renal crônica em tratamento hemodialítico: análise de fatores associados. Rev Bras Qual Vida. 2016;8(3):229-45. Disponível em: https://www.redalyc.org/ journal/3240/324053754016/html/.
Guerra-Guerrero V, Sanhueza-Alvarado O, Cáceres-Espina M. Qualidade de vida de pessoas em hemodiálise crônica: relação com variáveis sociodemográficas, médico-clínicas e de laboratório. Rev Latinoam Enferm.2012;20(5):838-46. doi:10.1590/S0104-11692012000600004.
Nunes C, Lobo A. Estudo das dimensões da qualidade de vida nos pacientes hemodialisados. Rev Enferm Referencia. 2012;3(8):39-45. doi:10.12707/RIII1215.
Medeiros R, Nunes M, Sousa A, Martha R, Nunes V, Costa T, et al. Qualidade de vida relacionada à saúde de indivíduos em hemodiálise. Rev Enferm UFPE Online. 2015;9(9):1018-27. doi:10.1590/1982-0194201900037.
Gomes LE, Lopes A, Castro C, Zanatta A, Pfaffenbach G, Julia A, et al. Qualidade de vida do paciente portador de doença renal crônica. Rev Cienc Inovacao. 2012;5(1):63-73. Disponívelem: https://faculdadedeamericana.com.br/ojs/index.php/Ciencia_Inovacao/article/ view/605/828/2333.
Manavalan M, Majumdar A, Harichandra Kumar KT, Priyamvada PS. Assessment of health-related quality of life and its determinants in patients with chronic kidney disease. Indian J Nephrol. 2017;27(1):37-43. doi:10.4103/0971-4065.179205.
Gerasimoula K, Lefkothea L, Maria L, Victoria A, Paraskevi T, Maria P. Quality of life in hemodialysis patients. Mater Sociomed. 2015;27(5):305- 9. doi:10.5455/msm.2015.27.305-309.
Gouvêa ECDP, Ribeiro AM, Aquino EC, Stopa SR, Höfelmann DA. Mortality trends due to chronic kidney disease in Brazil: an ecological study. Epidemiol Serv Saude. 2023;32(3):e2022230. doi:10.1590/S2237-96222023000300010.
Oliveira GL, Barros DSL, Silva DLM, Leite SN. Factors related to treatment adherence from the elderly perspective. Rev Bras Geriatr Gerontol. 2020;23(4):e200160. doi:10.1590/1981-22562020023.200160.
Silva MC, Oliva EFS, Rickli C, Braga LS. Epidemiological profile characterization of chronic kidney disease patients in a dialysis treatment unit in Campo Mourão-PR. Res Soc Dev. 2022;11(14):e57211427966.
Butyn G, Carvalho GM, Castro CJS, Silva GR, Arcaro G, Martins CM, et al. Quality of life assessment in chronic kidney disease patients undergoing renal replacement therapy. Braz J Health Rev. 2021;4(1):2785-98. doi:10.34119/bjhrv4n1-223.
Moura MRP, Silva MEVL, Nascimento MA, Assunção MJM, Câmara JT. Physical and functional capacity of chronic kidney disease patients undergoing hemodialysis treatment. Bol Conjuntura. 2024;18(54):464-94. doi:10.5281/zenodo.13316427.
Ministério da Saúde (BR). Protocolos clínicos e diretrizes terapêuticas. Brasília: Ministério da Saúde; 2020 [acesso em 2 jan 2025]. Disponível em: https://www.gov.br/conitec/pt-br/midias/protocolos/diretriz-cuidados-drc.pdf/view.
Drummond ED, Simões TC, Andrade FB. Avaliação da não adesão à farmacoterapia de doenças crônicas e desigualdades socioeconômicas no Brasil. Rev Bras Epidemiol. 2020;23:e200080. doi:10.1590/1980-549720200080.
Brasil. Projeto de Lei nº 1.751, de 2019. Altera a Lei nº 13.146, de 6 de julho de 2015. Câmara dos Deputados; 2019 [acesso em 28 dez 2024]. Disponível em: https://www.camara.leg.br.
Minas Gerais. Lei nº 24.654, de 2024. Estabelece os direitos das pessoas com Doença Renal Crônica no estado de Minas Gerais. Diário Oficial de Minas Gerais. Belo Horizonte; 2024.
Brasil. Lei nº 13.146, de 6 de julho de 2015. Estatuto da Pessoa com Deficiência. Diário Oficial da União.Brasília; 7 jul 2015.
Firmino AP, Moreira ACA, Dourado FW, Aguiar FAR. Quality of life of elderly individuals with chronic diseases monitored by the family health strategy. Enferm Foco. 2020;11(4):98-104. doi:10.21675/2357-707X.2020.v11.n4.
Paixão HM, Felício LLS. Health policies and psychonephrology: an experience report. Rev Multidiscip Nordeste Mineiro. 2024;7(1):15-23. doi:10.61164/rmnm.v7i1.2698.
Sousa ND, Araújo AM, Sousa DS, Lemos WGS, Rocha MHA, Negreiros ALB. Perception of chronic kidney disease patients about hemodialysis treatment. Saúde Coletiva (Barueri). 2021;11(64):5594-603. doi:10.36489/saudecoletiva.2021v11i64p5594-5603.
Carvalho BF, Inocêncio CC, Guadagnin E, Amorim E, Vianna PVC. WHOQOL-100 instrument and public policies: quality of life assessment of the target population of a housing policy. Saude Soc. 2021;30(2):e200324. doi:10.1590/S0104-12902021200324.
Centenaro APFC, Beck CLC, Silva RM, Andrade A, Costa MC, Silva EB. Waste collectors: life and work in light of social determinants of health. Rev Bras Enferm. 2021;74(6):e20200902. doi:10.1590/0034-7167-2020-0902.
Lima ABA, Leitão LCP, Jedlicka LDL. Quality of life perception of chronic kidney disease patients undergoing hemodialysis treatment in a city in northern Brazil. Rev Saude Coletiva UEFS. 2024;14(2):e9613. doi:10.13102/rscdauefs.v14i2.9613.
Albuquerque KR, Borges JWP, Rodrigues MTP. Non-adherence to pharmacological treatment of systemic arterial hypertension in primary health care. Cad Saude Colet. 2024;32(1):e393. doi:10.1590/1414-462X202432010393.
Cardoso AM, Dias W. Evaluation of the quality of social relationships of hemodialysis patients. Rev Iberoam Humanid Cienc Educ. 2024;10(10):4346-62. doi:10.51891/rease.v10i10.16308.
Almeida ED, Rodrigues LCS, Vieira JLF. Estimates of adherence to treatment of vivax malaria. Malar J.2014;13:321. doi:10.1186/1475-2875- 13-321.
World Health Organization (WHO). WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment. Geneva: WHO; 1996.
Marinho CLA, Oliveira JF, Borges JES, Silva RS, Fernandes FECV. Qualidade de vida de pessoas com doença renal crônica em hemodiálise. Rev Rene. 2017;18:396-403. Disponível em: https://www.redalyc.org/journal/3240/324053754016/html/.
Mattos M, Maruyama SAT. A experiência de uma pessoa com doença renal crônica em hemodiálise. Rev Gaucha Enferm. 2010;31(3):428- 34. doi:10.1590/S1983-14472010000300004.
Ottaviani AC, Bettoni LC, Paravini SCI, Say KG, Zazzetta MS, Orlandi FS. Associação entre ansiedade e depressão e a qualidade de vida de pacientes renais crônicos em hemodiálise. Texto Contexto Enferm.2016;25:e00650015. Disponível em: https://www.scielo.br/j/tce/ a/6QmQ3c5mQKcV9zXb6bK9W3z/.
Silva GD, Fernandes BD, Silva FA, Dias YCB, Melchiors AC. Qualidade de vida de pacientes com insuficiência renal crônica em tratamento hemodialítico: análise de fatores associados. Rev Bras Qual Vida. 2016;8(3):229-45. Disponível em: https://www.redalyc.org/ journal/3240/324053754016/html/.
Guerra-Guerrero V, Sanhueza-Alvarado O, Cáceres-Espina M. Qualidade de vida de pessoas em hemodiálise crônica: relação com variáveis sociodemográficas, médico-clínicas e de laboratório. Rev Latinoam Enferm.2012;20(5):838-46. doi:10.1590/S0104-11692012000600004.
Nunes C, Lobo A. Estudo das dimensões da qualidade de vida nos pacientes hemodialisados. Rev Enferm Referencia. 2012;3(8):39-45. doi:10.12707/RIII1215.
Medeiros R, Nunes M, Sousa A, Martha R, Nunes V, Costa T, et al. Qualidade de vida relacionada à saúde de indivíduos em hemodiálise. Rev Enferm UFPE Online. 2015;9(9):1018-27. doi:10.1590/1982-0194201900037.
Gomes LE, Lopes A, Castro C, Zanatta A, Pfaffenbach G, Julia A, et al. Qualidade de vida do paciente portador de doença renal crônica. Rev Cienc Inovacao. 2012;5(1):63-73. Disponívelem: https://faculdadedeamericana.com.br/ojs/index.php/Ciencia_Inovacao/article/ view/605/828/2333.
Manavalan M, Majumdar A, Harichandra Kumar KT, Priyamvada PS. Assessment of health-related quality of life and its determinants in patients with chronic kidney disease. Indian J Nephrol. 2017;27(1):37-43. doi:10.4103/0971-4065.179205.
Gerasimoula K, Lefkothea L, Maria L, Victoria A, Paraskevi T, Maria P. Quality of life in hemodialysis patients. Mater Sociomed. 2015;27(5):305- 9. doi:10.5455/msm.2015.27.305-309.
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2025-10-15
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Valente, J. da T., Sena, M. P. M. de, Ribeiro, C. H. M. A., Vieira, J. L. F., & Sena, L. W. P. de. (2025). Association between polypharmacy, medication adherence, and quality of life in patients with chronic kidney disease: a preliminary study in the Brazilian Amazon. O Mundo Da Saúde, 49. https://doi.org/10.15343/0104-7809.202549e17452025P
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