Regular access and adherence to medications of the specialized component of pharmaceutical services
ABSTRACT OBJECTIVE To investigate the prevalence of the adherence to the medications of the Specialized Component of Pharmaceutical Services and its association with regular access in users of these medications in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. METHODS This is a cross-sectional study with adults aged 20 years and over, who are users of medications of the Specialized Component of Pharmaceutical Services. Sampling was carried out consecutively for users who accessed the service of the Specialized Component of Pharmaceutical Services during the period from December 2014 to March 2015. Adherence was measured by the Brief Medication Questionnaire, and adherents were defined as those who did not present barriers to adherence in the three domains. Regular access was defined as getting all medications in the last three months, regardless of how it was obtained (paying or for free). Data analysis was performed using Poisson regression with robust variance. RESULTS We interviewed 414 subjects, being them mostly women (60.9%), with mean age of 55 years (SD = 13), and using a single medication of the Specialized Component of Pharmaceutical Services (68.1%). The prevalence of adherence to the medications used in the last seven days was 28.3% and the prevalence of free regular access was 46.1%, and 25.7% did not have access to all treatment. After adjusting for the number of medications in the Specialized Component of Pharmaceutical Services and the number of medications of continuous use, users who had free regular access in the last three months were 60% more likely to show adherence. For individuals with paid regular access, no association was found between access and adherence. CONCLUSIONS The regularity in the free access to the medications of the Specialized Component of Pharmaceutical Services has an impact on the behavior of users, contributing to their commitment to treatment and self-care. The Specialized Component of Pharmaceutical Services needs programming in order to avoid irregular access, which suggests a significant limitation of the drug policies in Brazil.