Como citar APA:
Caicedo, I., Jiménez, L. (2024) Patient safety and adherence to
pharmacological treatment: a diagnostic study at the León Becerra Hospital in Guayaquil.
Repique, 6 (2), 141-160
Vol. 6 Núm. 2
Julio - Diciembre 2024
e-ISSN: 2550-6676
pp 141-160
Patient safety and adherence to pharmacological treatment: a
diagnostic study in the León Becerra Hospital of Guayaquil
Iliana Alicia Caicedo Castro
*
Luisana Jiménez
*
Abstract
The growing number of scientific research and publications on
patient safety has provided a solid evidence base that highlights
the magnitude and impact of safety problems, and these studies
have identified adverse drug events as critical factors. Students and
teachers of the TES Pharmacy Assistance career, in response to this
problem, conducted a diagnostic study as part of the research
project "Promotion strategies on adherence to drug treatment",
with the aim of characterizing the current status of patients with
NCDs in relation to adherence to drug treatment at the León
Becerra Hospital in Guayaquil, using direct methods such as the
Morisky-Green Test (MAQ: Medication Adherence Questionnaire)
and the questionnaire. The results conclude that patients'
therapeutic non-adherence reveals a significant concern that should
be urgently addressed; adherence to the prescribed therapeutic
regimen is fundamental for the control of NCDs and the reduction
of complications and mortality. Therapeutic nonadherence is a
multifaceted problem influenced by a variety of factors, related to
the patient, the treatment, the health system, health professionals,
and socioeconomic conditions. Given this situation, it is necessary
MsC. Instituto Superior Tecnológico Universitario Espíritu Santo, iacaicedo@tes.edu.ec
https://orcid.org/0009-0009-9744-9608
MsC. Instituto Superior Tecnológico Universitario Espíritu Santo, ljimenez@tes.edu.ec
https://orcid.org/0000-0002-4853-2052
Iliana Alicia Caicedo Castro , Luisana Jiménez
142
to implement strategies to increase adherence to treatment and
patient safety. These actions should be supported by public health
policies that facilitate access and continuity of treatment for
patients.
Keywords:
Patient safety, adherence, chronic non-communicable
diseases.
Seguridad del paciente y adherencia al tratamiento
farmacológico: un estudio diagnóstico en el Hospital León
Becerra de Guayaquil
Resumen
El creciente número de investigaciones y publicaciones científicas
sobre seguridad del paciente ha proporcionado una sólida base de
evidencia que pone de manifiesto la magnitud y el impacto de los
problemas de seguridad, y estos estudios han identificado los
eventos adversos a medicamentos como factores críticos.
Estudiantes y docentes de la carrera de Asistencia Farmacéutica del
TES, en respuesta a esta problemática, realizaron un estudio
diagnóstico como parte del proyecto de investigación "Estrategias
de promoción en la adherencia al tratamiento farmacológico", con
el objetivo de caracterizar el estado actual de los pacientes con
ECNT en relación a la adherencia al tratamiento farmacológico en
el Hospital León Becerra de Guayaquil, utilizando métodos directos
como el Test de Morisky-Green (MAQ: Cuestionario de Adherencia
a la Medicación) y el cuestionario. Los resultados concluyen que la
no adherencia terapéutica de los pacientes revela una
preocupación significativa que debe ser abordada con urgencia; la
adherencia al régimen terapéutico prescrito es fundamental para el
control de las ENT y la reducción de las complicaciones y la
mortalidad. La no adherencia terapéutica es un problema
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
143
multifacético en el que influyen diversos factores, relacionados con
el paciente, el tratamiento, el sistema sanitario, los profesionales de
la salud y las condiciones socioeconómicas. Ante esta situación, es
necesario implementar estrategias para aumentar la adherencia al
tratamiento y la seguridad del paciente. Estas acciones deben ser
apoyadas por políticas de salud pública que faciliten el acceso y la
continuidad del tratamiento de los pacientes.
Palabras clave:
Seguridad del paciente, adherencia, enfermedades
crónicas no transmisibles.
Received : 09-03-2024
Approved: 12-05-2024
INTRODUCTION
Patient safety has gained great importance in recent years. Since
2019, World Patient Safety Day has been celebrated, with the aim
of raising awareness of the relevance of this topic in all areas and
sectors involved in healthcare. "Patient safety (PS), or the deliberate
attempt to avoid harm to patients as a result of care, is an essential
component of quality of care and a prerequisite for the
performance of any clinical practice" Rocco & Garrido (2017) cited
by (Lloacana, Vasquez, & William, 2023)..
According to the World Health Organization (2009), quality and
safety in patient care constitute a technical and ethical obligation of
those who provide the service, through the transparency of the
processes and results of the actions developed by the
aforementioned health systems. Quality of care being the degree
to which health services provided to individuals and populations
increase the probability that the intended health effects occur and
these are consistent with the professional knowledge of the
moment; cited by (Ecuador, Ministerio de Salud Pública, 2016).
Iliana Alicia Caicedo Castro , Luisana Jiménez
144
Patient safety is a crucial component in medical care and one of the
major concerns in any health system; one of the causes that
jeopardizes patient safety is lack of adherence to treatment;
however, in clinical practice this fact is not considered as one of the
main causes of therapeutic failure.
The World Health Organization (WHO) defines therapeutic
adherence as "the degree to which a person's behavior-taking
medication, following a dietary regimen, and executing lifestyle
changes-matches the agreed-upon recommendations of a health
care provider" cited by (Ortega, Sánchez, Óscar, & Ortega, 2018)..
A recent report by the World Health Organization (WHO),
nonadherence is a "major global problem "cited by. (Ortega,
Sánchez, Óscar, & Ortega, 2018).. In 2007 the National Council on
Patient Information and Education indicated that, "one out of every
two patients forgets to take their medication; three out of every ten
patients stop taking their medication once treatment has started;
and one out of every four patients takes a lower dose than
prescribed by their physician; all of this, with the impact and
economic expense that it entails" (Elizondo & Braceras, 2019).
Lack of adherence to treatment has been associated with poorer
clinical outcomes in a wide variety of medical conditions. Lack of
medication adherence can lead to inadequate disease control,
increased complications, and frequent hospitalizations. It also has
significant economic implications; several studies have shown that
the costs associated with the medical care of patients who do not
adhere to their treatments are significantly higher due to the need
for additional medical interventions, more intensive treatments and
hospitalizations.
Non-adherence is undoubtedly a significant cause that jeopardizes
patient safety and can lead to therapeutic failure. However, in
clinical practice, this reality is often overlooked due to
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
145
underestimates of the problem, a predominant focus on immediate
clinical factors, limitations in resources and time, and deficiencies in
patient communication and education. The present study aims to
characterize the current state of adherence to pharmacological
treatment in patients with NCDs at the León Becerra Hospital in
Guayaquil.
The growing importance of patient safety in recent times reflects a
broad and deep recognition of the challenges and opportunities in
healthcare. The World Health Organization (WHO) and other
international organizations have launched various initiatives and
campaigns to improve patient safety and to raise awareness and
promote global action in this regard.
Patient safety is critical to maintaining public confidence in the
healthcare system; patients and their families must trust that they
are receiving safe, quality care. Improving safety practices helps to
strengthen this trust and ensure more effective and humane care.
To improve therapeutic outcomes and patient safety, it is crucial to
recognize and address treatment adherence as a central
component of comprehensive medical care.
Non-adherence to treatment is a worldwide problem whose origin
is multifactorial (Orueta et al., 2008). It is the cause of reduced
health outcomes and rising healthcare costs (Dilla et al., 2009). It
may be due to factors related to the pathology, the treatment, the
patient, the healthcare professional or the socioeconomic
environment (Pagès-Puigdemont and Valverde-Merino, 2018) cited
by. (Villegas, 2022).
Despite pharmacological advances and research into the control of
chronic diseases, health outcomes are not as expected due to lack
of adherence, which considerably reduces the efficacy and
efficiency of treatments. Some studies place it for patients with
chronic diseases at 50%. Lack of adherence is as high as 75% in
Iliana Alicia Caicedo Castro , Luisana Jiménez
146
psychiatric diseases, 70% in asthmatic patients, 50% in patients with
arterial hypertension (AHT), cholesterol, or diabetes, and can
decrease to 30% in acute pathologies (Rigueira, 2001 cited in
(García, Gil, Murillo, Vázquez, & Vergoñós, 2017)..
The degree of adherence and the effectiveness of treatments are
closely related, and this relationship is critical to achieving optimal
outcomes in medical care. Patients who adhere to their treatments
generally experience an improvement in their quality of life due to
better symptom control and a lower incidence of complications.
This is vital to their emotional and social well-being.
Most authors refer to adherence as a dichotomous variable and
classify patients as adherent or nonadherent. However, taking into
account that patients may be adherent to some aspects of their
treatment and not to others, it may sometimes be more interesting
to take a quantitative approach to adherence and speak of degrees
of adherence and of fully adherent, partially adherent, and
predominantly nonadherent patients (García, Gil, Murillo, Vázquez,
& Vergoñós, 2017).
According to intentionality, intentional NA is that in which the
patient is aware of the action, and this decision may be influenced
by the patient's attitudes, expectations and beliefs. In unintentional
NA, patients, due to certain limitations and without intending to do
so, become NA (García, Gil, Murillo, Vázquez, & Vergoñós, 2017)..
By temporal factors, several categories are defined taking into
account the time and how it occurs (Rubio-Valera, 2012 cited by.
(García, Gil, Murillo, Vázquez, & Vergoñós, 2017):
• Non-initiation or lack of primary adherence, in which the
initial mediation is not withdrawn.
• Late initiation is the delay in starting treatment.
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
147
• Early discontinuation is the interruption of treatment earlier
than prescribed.
• Underdosing is the administration of insufficient doses to
achieve the desired result.
• Overdosage, includes excessive doses to achieve the
desired therapeutic effect.
For the WHO cited by (Pagès & Valverde, 2020)there are five
interacting dimensions that influence therapeutic adherence:
1. Socioeconomic factors.
2. Treatment-related factors.
3. Patient-related factors.
4. Disease-related factors.
5. Factors related to the health care system or equipment.
It is very important to investigate these dimensions in depth in
practice in order to influence the community through promotional
actions; taking into account that the lack of adherence to treatment
in the context of Chronic Non-Communicable Diseases is
considered a serious health problem worldwide
METHODOLOGY
A polymodal or mixed methodology was used, combining
qualitative and quantitative methods and techniques, to obtain
reliable information from patients with NCDs at the León Becerra
Hospital in Guayaquil, in relation to adherence to pharmacological
treatment.
The research is field-based, allowing the researchers to interact
directly with patients with NCDs at the León Becerra Hospital in
Guayaquil, which guarantees a more accurate and relevant data
collection, accurately reflecting the current state of adherence to
pharmacological treatment.
Iliana Alicia Caicedo Castro , Luisana Jiménez
148
Descriptive and hermeneutic research is also followed, because it
focuses on the interpretation of the data obtained to characterize
the current status of patients with NCDs in relation to adherence to
pharmacological treatment.
The theoretical methods used are: analytical-synthetic and
inductive-deductive; the empirical methods used are observation,
interview, survey and test, which allow characterizing the current
state of adherence to pharmacological treatment in patients with
NCDs at the León Becerra Hospital in Guayaquil.
The study population consisted of 92 patients with NCDs at the
León Becerra Hospital in Guayaquil and 8 health professionals (4
pharmacists, 2 physicians, 2 nurses).
The Morisky-Green Test (MAQ: Medication Adherence
Questionnaire) and the questionnaire were selected from among
the various methods used to measure therapeutic adherence. The
first version of the Morisky-Green Test (MAQ), which consists of 4
questions (4-item Morisky Medication Adherence Scale: MMAS-4)
with dichotomous yes or no answers, was selected. The Morisky-
Green test is one of the best known and has been validated for
chronic diseases; in the present study it is applied to patients with
NCDs at the León Becerra Hospital in Guayaquil to measure
adherence to drug treatment.
The questionnaire is also used because it is very useful to determine
adherence to pharmacological treatment in patients with NCDs at
the León Becerra Hospital in Guayaquil, and it is a simple and
inexpensive method. The questionnaire is subjected to a validation
process by experts to evaluate the effectiveness of the items
determined and formulated.
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
149
RESULTS
Once the data collection instruments were applied, the results were
processed, tabulated and analyzed; in this process it was identified
that 68% of the population is female and 32% male. Age is another
very important factor; many studies have shown that older people
have greater adherence to pharmacological treatment, data that
are corroborated in this study; 42% of the research population is 60
years or older, 32% is in the range of 49 to 59 years, between 29
and 48 years is 18% of patients and from 18 to 28 8%, see Table 1.
Table 1.
General data
GENRE
Female
63
Male
29
AGE
18-28
7
8%
29-48
17
18%
49-59
29
32%
60 or more
39
42%
Eighty percent of the patients surveyed suffer from some NCD (see
Figure 1), of whom more than 40% are 60 years of age or older; this
data reinforces the existing knowledge that NCDs are more
prevalent in older persons. Advanced age is a non-modifiable risk
factor, and this age group tends to have a greater accumulation of
risk factors and exposure throughout their lives. Another significant
fact is that only 12% of patients with NCDs are in the 18-28 age
range. Although this percentage is lower, it should not be
Iliana Alicia Caicedo Castro , Luisana Jiménez
150
underestimated. The presence of NCDs in young adults could
indicate the emergence of early health problems, possibly related
to unhealthy lifestyles adopted from an early age.
Chronic Non-Communicable Diseases (NCDs) represent a
significant burden for health systems and people's quality of life.
These diseases include pathologies such as hypertension (77%),
diabetes (70%), respiratory diseases (54%), cardiovascular diseases
(53%), digestive diseases (36%), osteoporosis (30%). These
diseases, in many cases, are linked to modifiable risk factors such
as smoking, sedentary lifestyle, poor diet, and alcohol
consumption.
Effective management of NCDs depends to a large extent on
patients' knowledge of their condition, including causes,
symptoms, treatment options, and prevention and self-care
measures. However, 51% of NCD patients surveyed indicate that
they know nothing about their disease and 28% consider that they
know something. This data is alarming because it suggests that
more than half of the patients are completely uninformed about
their condition, which can lead to poor disease management,
worsening of symptoms, and an increase in associated morbidity
and mortality.
58% of patients surveyed report that their diseases affect their
quality of life. This indicates that a significant majority of patients
experience a marked decrease in their well-being and ability to
perform daily activities due to their disease. This can include
physical limitations, chronic pain, fatigue, and emotional problems
such as depression and anxiety. Thirty-one percent of patients
indicate that their condition has affected their life somewhat.
Although this group is not as severely affected as the previous
group, there is still a noticeable impact on their quality of life.
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
151
Chronic Non-Communicable Diseases (NCDs) are long-term
conditions that require continuous and often intensive
management; pharmaceutical treatment is essential to control
symptoms, prevent complications and improve patients' quality of
life. The fact that 80% of the patients surveyed follow a
pharmaceutical treatment to treat their disease is positive in the
sense that most patients are receiving some type of medical
intervention to manage their condition. The remaining 20% of
patients indicate that they are not following any treatment; this is
concerning because it suggests that one-fifth of patients with NCDs
are not receiving the necessary treatment, which may lead to poor
disease control, more rapid disease progression, and an increased
risk of serious and potentially life-threatening complications.
Patients on pharmaceutical treatment are more likely to keep their
disease under control, reduce symptoms and prevent
complications. This can translate into improved quality of life,
increased ability to perform daily activities and a reduction in
hospitalizations and emergency visits.
However, analysis of the results of the survey on the patients'
perception of the effectiveness of their health treatments reveals a
complex and worrying situation; only 24% of the patients surveyed
consider that the treatment they are undergoing greatly improves
their state of health, which suggests that, for this group, the
treatment meets their expectations and possibly the therapeutic
objectives set. Forty-seven percent of those surveyed say that the
treatment somewhat improves their state of health, which indicates
that, although there is a perception of improvement, it is not
significant enough.
The most alarming finding is that 29% of the patients surveyed
indicated that they have not improved at all with treatment; this
percentage reflects significant dissatisfaction and raises serious
Iliana Alicia Caicedo Castro , Luisana Jiménez
152
concerns about the effectiveness of the treatments administered.
The reasons behind this perception could be varied: from
inadequate or poorly administered treatments, lack of accurate
diagnosis, to more structural problems of the health system such as
access and quality of service.
These results underscore the need for a thorough evaluation of the
treatments being offered. It is crucial to investigate the causes
behind patients' perception of little or no improvement in order to
implement strategies to increase the effectiveness of treatments
and patient satisfaction. It may be necessary to adjust protocols,
personalize treatments and improve the training of healthcare
professionals, as well as to ensure closer follow-up of patients to
adjust therapies according to their evolution. In addition, it is
essential to consider patients' opinions and experiences as an
integral part of the process of improving health services.
Regular medical check-ups are an essential component of effective
disease management and pharmaceutical treatment follow-up.
These check-ups allow health professionals to closely monitor the
evolution of the disease and the patient's response to treatment.
According to the data obtained in the survey, 47% of patients
always attend their medical check-ups, 40% do so regularly and
13% never attend their medical check-ups. Although this last figure
represents a small percentage, it is of great concern because it
limits the opportunities for early detection of complications
associated with the disease; regular medical control helps to
identify subtle changes in the patient's state of health that may
indicate the onset of complications, allowing timely intervention
that can prevent the deterioration of the patient's condition.
Physical activity is another essential component for maintaining
health and well-being at all ages, especially in older adults. It is
concerning that only 17% of the patients surveyed confirm always
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
153
engaging in physical activity, regularly engage in physical activity
35%, and 48% indicate that they never engage in physical activity.
The fact that almost half of the patients surveyed do not participate
in any form of physical activity is of concern, as sedentary lifestyles
are associated with a variety of health problems, such as
cardiovascular disease, type 2 diabetes, obesity, loss of muscle and
bone mass, and cognitive impairment. Physical inactivity can also
negatively affect a patient's mood and quality of life.
The survey reveals important information about the eating habits of
the NCD patients surveyed, a positive aspect such as the fact that
45% confirm practicing good eating habits and areas of concern
because 34% state that they only sometimes follow healthy eating
practices, and 21% never do so, this group of patients who do not
practice healthy eating habits are at greater risk of developing
health problems related to poor diet, such as obesity and nutritional
deficiencies, among others; which further complicates their health
status; and highlights the need for specific interventions to educate
and support this segment of the population in adopting better
eating habits.
Finally, respondents were asked to list the most important factors
that they considered caused their illness, listing them in order of
importance, and these are the results obtained:
Forty-nine percent of the respondents indicated unhealthy diet as
the first. Diets high in saturated fats, sugars and salt, and low in
fruits, vegetables and fiber, contribute to the development of
obesity, hypertension, type 2 diabetes and cardiovascular disease.
40% consider physical inactivity to be the main cause of their
disease. Lack of physical activity is associated with an increased risk
of cardiovascular disease, type 2 diabetes, some types of cancer
and obesity.
Iliana Alicia Caicedo Castro , Luisana Jiménez
154
52% believe that the practice of unhealthy habits is one of the
causes of their disease. Unhealthy habits such as tobacco use is one
of the main risk factors for NCDs, especially for cardiovascular
diseases, cancer (especially of the lung, mouth, throat and
esophagus) and chronic respiratory diseases such as chronic
obstructive pulmonary disease. On the other hand, there is the
excessive and regular consumption of alcohol, which leads to liver
disease, cancer, high blood pressure and heart problems.
38% indicate that one of the causes of their health condition is non-
adherence to medical treatment, self-medication and inappropriate
use of medications. This is crucial, as self-medication and non-
adherence to prescribed medications can lead to adverse effects,
dangerous drug interactions and ineffectiveness of treatment.
Adherence to treatment is fundamental to the successful
management of chronic noncommunicable diseases.
Analysis and discussion of the main results of the Morisky-Green
Test (MAQ) applied to patients with NCD at the León Becerra
Hospital in Guayaquil.
The evaluation of the degree of therapeutic adherence through the
Morisky Green Test identified that more than 55% of the patients
surveyed were not adherent to the therapeutic regimen prescribed
for their disease.
A patient is considered to be adherent when the sequence of
answers to the test questions is: No-Yes-No-No. In this case this
sequence is not complied with: in the first question 61% of the
patients answer Yes, which indicates non-adherence; in the second
question more than 50% answer No; the third and fourth questions
the results behave in the same way more than 50% answer Yes; as
shown in Table 2.
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
155
This finding is of great concern because therapeutic adherence is
essential for the effective management of chronic diseases and
prevention of complications. Lack of adherence means that patients
are not taking their medications consistently and appropriately,
which can result in inadequate control of their condition. In
addition, it directly impacts treatment efficacy and patient health
outcomes.
Table 2.
Results of the Morisky-Green test.
1.- Do you ever forget to take your medications to
treat your illness?
YES
56
61%
NO
36
39%
2.- Do you take your medications at the indicated
times?
YES
42
46%
NO
50
54%
3.- When you feel well, do you stop taking the
medication?
YES
53
58%
NO
39
42%
4.- If you ever feel sick, do you stop taking it?
YES
58
63%
NO
34
37%
According to the health professionals interviewed, many of the
patients suffer from more than one NCD. Similarly, all those
Iliana Alicia Caicedo Castro , Luisana Jiménez
156
interviewed consider that the NCDs with the highest prevalence
are: arterial hypertension, diabetes mellitus, hypothyroidism, heart
and respiratory diseases, while those with the lowest incidence are
rheumatoid arthritis, osteoporosis and digestive diseases, data that
coincide with those obtained by the patients under study.
Regarding the main causes of NCDs, most of the interviewees
agree that they are related to age, poor eating habits and excessive
consumption of alcohol and tobacco. Other interviewees consider
genetic predisposition, stress and mental health, such as
depression and anxiety, as possible causes that influence the onset
and management of NCDs.
The evaluation of the degree of therapeutic adherence reveals a
significant concern among health professionals, as most of them
consider it to be low. According to those interviewed, more than
50% of their patients do not follow the prescribed treatment for
their diseases. This information is alarming considering that
adherence to treatment is fundamental for the effective control of
Chronic Non-Communicable Diseases (NCDs). When patients do
not follow the recommended therapeutic regimen, the treatment
loses effectiveness, which can lead to a worsening of the disease
and an increase in the appearance of complications.
Respondents believe that adherence to treatment not only
improves clinical outcomes, but can also improve quality of life by
reducing symptoms and complications associated with NCDs.
Patients who adhere to their treatments often experience an
improvement in their overall well-being, which in turn may motivate
them to continue with their therapeutic regimen.
Finally, health professionals were asked about the factors that
influence therapeutic nonadherence; the responses were diverse,
indicating that therapeutic nonadherence is a multifaceted problem
influenced by a variety of factors, such as:
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
157
• Lack of patient knowledge and understanding: patients who
do not attach importance to treatment and are unaware of
the consequences of not adhering to treatment.
• Forgetfulness: forgetting to take medications is a common
cause of non-adherence, especially in complex treatments or
with multiple daily doses.
• Side effects: adverse effects of medications may lead
patients to stop taking them or reduce the dosage on their
own.
• Duration of treatment: long-term treatments can be
discouraging and difficult to maintain, especially if patients
do not see immediate improvements in their condition.
• Access to medications: difficulty in obtaining medications,
whether due to problems of availability, high costs or
geographic barriers, can affect adherence.
• Educational level: educational level is associated with
understanding of the disease and the therapeutic regimen,
which can negatively affect adherence.
• Social environment and family support: the lack of family
support, friends or caregivers makes it difficult to follow
medical treatment.
CONCLUSIONS
The study made it possible to characterize the current state of
patients with chronic non-communicable diseases in relation to
therapeutic adherence at the León Becerra Hospital in Guayaquil,
through the use of direct methods such as the Morisky-Green Test
(MAQ: Medication Adherence Questionnaire) and the
questionnaire.
The high prevalence of NCDs in people over 60 years of age
suggests the need to strengthen geriatric health systems,
Iliana Alicia Caicedo Castro , Luisana Jiménez
158
implement early detection programs, and develop appropriate
treatment and management strategies for this population. It is also
necessary to promote education on self-care and the adoption of
healthy habits to prevent complications.
The high percentage of patients with NCDs who are unaware of
their disease or have only partial knowledge is a serious problem
that affects both individual and public health. It is critical to address
this knowledge gap through education, access to information, and
ongoing support to improve the management of NCDs.
The low perception of patients regarding the effectiveness of their
medical treatments underscores the need to conduct a thorough
evaluation of the treatments being offered; to investigate the
causes behind this fact in order to implement strategies to increase
the effectiveness of treatments and patient safety.
The evaluation of the degree of therapeutic adherence reveals a
significant concern that should be addressed urgently, given that
adherence to treatment is the most relevant element for the control
of NCDs and the reduction of complications and mortality. Given
this situation, efforts should be redoubled to improve adherence to
treatment. This includes both interventions at the individual level
and public health policies that facilitate access and continuity of
treatment for patients with NCDs.
Non-adherence to treatment is a multifaceted problem influenced
by a variety of factors, including those related to the patient, the
treatment, the health care system, health care professionals and
socioeconomic conditions.
Repique. Revista de Ciencias Sociales.
Vol. 6 No. 2 – 2024
Julio - Diciembre
159
REFERENCES
Elizondo, I., & Braceras, L. (2019). Adherence to medications.
Bilbao Medical Gazette, 146-148. Retrieved from
https://docplayer.es/170799171-Gaceta-medica-de-
bilbao.html#google_vignette
García, E., Gil, M., Murillo, M. D., Vázquez, J., & Vergoñós, A.
(2017). Dispensing, adherence and appropriate use of
treatment:practical guide for the community
pharmacist.(EDITTEC, Ed.) Spain: SEFAC. Retrieved from
https://www.sefac.org/sites/default/files/2017-
11/Adherencia_0.pdf
Lloacana, F., Vásquez, P., & William, L. (2023). Contribution and
application of patient safety in Latin American clinical
laboratories. PENTACIENCIAS Multidisciplinary Refereed
Scientific Journal, 5(3), 460-470. Retrieved from
https://editorialalema.org/index.php/pentaciencias/article/v
iew/564/759
Ortega, J., Sánchez, D., Óscar, R., & Ortega, J. M. (2018).
Therapeutic adherence: a health care problem. Acta médica
Grupo Ángeles, 16(3), 226-232. Retrieved from
http://www.medigraphic.com/actamedica
Pagès, N., & Valverde, I. (December 2020). Therapeutic adherence:
modifying factors and strategies for improvement. Ars
Pharmaceutica, 59(4), 1-8. Retrieved from
https://revistaseug.ugr.es/index.php/ars/article/view/7357
Villegas, M. I. (2022). Adherence to pharmacological treatment.
Faculty of Pharmacy. Seville: University of Seville. Retrieved
from
Iliana Alicia Caicedo Castro , Luisana Jiménez
160
dus.us.es/bitstream/handle/11441/143367/RUGER%20ALV
AREZ%20ANA.pdf?sequence=1&isAllowed=y
