Adhesion to treatment: Permanent construction in search of the single health system's user autonomy

Abstract

The adhesion to the treatment of diseases, such as AIDS, is a permanent challenge to the health professioanls, due to the implications that exceed the ill individual and reach not only the family, but the community. Improve the adhesion to antiretroviral therapy for people who live with HIV/AIDS. The work began in 2012 at Hospital Dia do Hospital das Clínicas from the Campinas State University. The population is made up by people who live with HIV/AIDS and other infectious diseases. In 2012, data from a random sample of 141 users with AIDS was collected from 945 allocated to assess the adhesion, considering as adherent that one who ingested 95% or more medicines prescribed in the last three days previously to the interview. From 141 users with adhesion analyzed in 2012, it was observed the 81.6% adhesion rate, being higher than the one found in 2003, which was 73.3%. From March to June 2016, 268 patients were absent and convoked to consultations and 163 (61%) attended the convocation for medical consultation with follow-up by the nurse. Three satisfaction researches were held in the period. The structural and process non-compliances were corrected after a checklist analysis with 1,479 items. The allocated customer base in 2015 was 2,350 patients. The absenteeism was decreased with the medical consultation confirmation by phone. The nursing process and the "TARV showcase" preparation were some of the safety measures. The patients presented social, clinical and therapeutical complexity, which may limit the adhesion rate rising.