Systemic Lupus Erythematosus: a comparative study between models of intervention for treatment adherence

Defense of doctoral thesis

Title: Systemic Lupus Erythematosus: a comparative study between models of intervention for treatment adherence

Author: Amrita Bastos Neder

Summary:

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease of the connective tissue, and multisystem autoimmune, characterized by the production of autoantibodies directed mainly against nuclear antigens resulting in tissue damage. Usually evolve with periods of exacerbation interspersed with periods of remission and great clinical polymorphism. Occurs preferably female literacy, in the period between menarche and menopause. The treatment is diverse; the recommendations include use of medications, diet hipossódica, use of sunscreen and practice of physical activities, indicated according to the clinical manifestations and severity. The rules for treatment are complex, making it difficult to the membership. This research studied the effects of three intervention conditions on treatment adherence behaviors in women with LES. It is a longitudinal study with interventions in intervals of 30, 60, 90 and 120 days. Participated in 15 patients with SLE, according to the criteria of the American College of Rheumatology in following the reference clinic in rheumatic diseases a public health hospital in the city of Belém-PA. Were used as inclusion criteria: diagnosis of LES for at least one year; age between 18 and 45 years; having completed elementary school or taking the last year; reside in the metropolitan area of Bethlehem or municipalities near the capital; present moderate level of disease activity, according to SLEDAI-2 k. Were used: observation forms of medical consultations; medical records analysis protocols; screenplays interviews; Checklist; self-monitoring registration forms; visual analog scale of pain; Beck Depression Inventory (BDI); assessment questionnaire SF-36 quality of life and the disease activity index SLEDAI-2 k. The participants were divided into three intervention conditions. On the Condition (n = 5), the participants were exposed to the routine of the ambulatory and the four interviews. In Condition B (n = 5), the participants underwent eight interviews with checklist usage, beyond the routine outpatient clinic. Provided that C (n = 5), the participants were exposed to the routine outpatient and eight interviews with use of checklist and self-monitoring registration forms. The data obtained were analyzed quantitative and qualitative, comparing the results at the beginning with the end of the study conducted in 120 days with each participant. It was observed that all participants, regardless of condition, showed good index of adherence to the treatment at the end of the study and reduction in indicators of activity of the LES. However, the participants of the condition (C) kept gains even after the withdrawal of the intervention procedure, suggesting better adhesion index (average of 95.71).

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