Enfermeras de Atención Primaria opinan, analizan y proponen mejoras en el manejo de la adherencia farmacológica

Abstract

Aim: To find out how primary care nurses perceive and handle pharmacological non-adherence and to identify areas for improvement. Methods: A qualitative study including focal groups and in-depth interviews was carried out in May-June 2009 in the Sanitary Area V of Asturias, Spain. Interviews were recorded and transcribed in order to analyze the contents. Results: Data on how nurses assess and handle pharmacological adherence are presented, as well as the difficulties they face and proposals for improvement. They believe this problem should be taken care of by both practitioners and nurses. The difficulties they find are: prescription fields deficiently recorded; the sparse revalidation of prescriptions by general practitioners; the lack of activity recording protocols; and the insufficient training on pharmacology nurses have. They reject the marker system used by the community Healthcare System because the daily routine of the nurses is not appreciated. They propose improving the records, the availability of pharmacology training and nursing training, the development of adherence assessment protocols in the Sanitary Area and the implementation of multidisciplinary programs.Conclusions: Nurses give great relevance to the pharmacological non-adherence issue, and they devote time and effort to it. The impediments they highlight reduce the effectiveness of the interventions carried out. Training is necessary for a better handling of this issue, as well as the joint multidisciplinary participation of practitioners, nurses, pharmacists, social workers, clinical psychologists and managers, patients and relatives so as to implement strategies which may optimize the outcomes.