Avaliação do perfil epidemiológico, clínico, laboratorial e adesão ao tratamento dos pacientes com esclerose sistêmica: um estudo de corte transversal

Abstract

INTRODUCTION: Systemic sclerosis (SS) is an autoimmune disease characterized by vasculopathy, inflammation, collagen deposition and fibrosis of the skin and internal organs. SS is considered the most severe connective tissue disorder with a high morbimortality. Therefore, it is a disease demands extreme medical attent ion as fibrosis progresses uninterruptedly and has a difficult management. Therapeutical approach consistis of treating the symptoms distinctly. Of note, there is a significant daily administration of medication which needs a rigid control by the patient. METHODS: A descriptive cross sectional study with an analytical component was carried out in patients with SS followed in the rheumatology outpatient care of IMIP from August/2017 to July/2018. Clinical, epidemiological and laboratorial data were collect ed by interview and review of hospital record s . Treatment adherence was evaluated by the use of MAT and Morisky questionnaires. Statistical analysis was performed useing GraphPad Prim software v.6.0. RESULTS: The main findings were the significant associ ation between the visual analog scales (VAS) scores of interference on activities during last week and the age of patients, p<0.01. According to Morisky questionnaire, 27% of patients had poor adhesion and regarding MAT, 32% were non adherent to treatment. When comparing adherent and non adherent patients there was significant differences interference of ulcers on activities, p=0.0123. Patients who forget to restore the medication had higher interference of Raynaud's phenomenon on activities compared to tho se who do not, p=0.0252. Age showed a relevant negative correlation with the global evaluation of the disease, (r= 0.5748, p= 0.0051). CONCLUSION: The correlation between complaints of the patients and alterations found in clinical tools reinforces the importance of valuing those complaints during treatment. In addition to that, to be alert to each patient particularities is of great value for a more brief and precise intervention. There is also a necessity of more assistance based policies and individua l strategies of treatment adhesion, Therefore, optimizing pharmacological adhesion, not only relieves the symptoms and modifies the progression of the disease, but can be also fundamental to the therapeutical approach of the patients with Systemic Sclerosi s.