MEASUREMENT OF THE THERAPEUTIC BREACH IN THE CHRONIC PATIENT COMPLEX AND MODEL OF ATTENTION ADVANCED CRONICITY IN TWO PRIMARY CARE EMERGENCY CENTERS OF THE PROVINCE OF BARCELONA

OBJECTIVE. To determine the adherence to pharmacological treatment in patients identified as PCC / MACA in two primary care emergency centers in the province of Barcelona during 2016. METHODOLOGY. Observational descriptive study of exploratory and transversal type. A total of 379 subjects were included. RESULTS. Average age 81.8 years of which 52.8% were women and the rest were men. They were identified as PCC 89.4% and 10.6% as MACA. The predominant risk factors were hypertension, followed by obesity, diabetes and dyslipidemia. 98.4% of patients have multiple pathologies. We obtained a median of Barthel Index of 85, of the Zarit Test 54, of the probability of annual income 18.2% and of daily consumption of 11 drugs. Therapeutic compliance was observed in 274 (72.3%) patients, presenting a higher percentage in MACA versus PCC (p = 0. 058). Compliance was higher when the caregiver was a family member, and lower when the caregiver was institutionalized or had not caregiver (p = 0.008). In terms of non-compliance, diabetics (p = 0.010) and obese patients (p = 0.013) were more frequently forgotten than the rest of patients. The correct intake of all medication is associated with a higher level of study (p = 0.028). CONCLUSION. Non-compliance due to forgetfulness is less in patients who have the direct support of children, therefore the programs should enhance the involvement whenever possible of the children in the care of their elders. In the population of diabetics, non-compliance is higher than in the rest of the population, and a more exhaustive follow-up of these patients is necessary. On the other hand, women are more deviant than men and it is not due to lack of responsibility, but rather lack of support