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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(02): s00441779608
DOI: 10.1055/s-0044-1779608
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The impact of the socioeconomic factor on Parkinson's disease medication adherence: a scoping review

O impacto do fator socioeconômico na adesão à medicação na doença de Parkinson: uma revisão de escopo
Gustavo Gil 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
,
Michelle H. S. Tosin 
2   Rush University Medical Center, Department of Neurological Sciences, Chicago, Illinois, United States.
,
Henrique Ballalai Ferraz 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
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Abstract

Background Therapeutic adherence is a decisive issue on chronic disease management in patients requiring long-term pharmacotherapy, such as Parkinson's disease (PD). Although it is well known that socioeconomic factor is a barrier to medication adherence in many chronic diseases, its impacts on PD still need to be investigated.

Objective Explore what and how socioeconomic factors impact medication adherence in people with PD.

Methods We carried out a scoping review across three databases to identify studies exploring what and how socioeconomic factors impact medication adherence in people with PD considering eight attributes: 1. educational level, 2. disease-related knowledge, 3. income, 4. cost of medication, 5. drug subsidy (meaning presence of subsidies in the cost of medication), 6. employability, and 7. ethnicity (black, indigenous, immigrants).

Results Of the 399 identified studies (Embase = 294, Medline = 88, LILACS = 17), eight met inclusion criteria. We identified factors covering the eight attributes of socioeconomic impact, and all of them negatively impacted the medication adherence of people with PD. The most prevalent factor in the studies was low patient educational level (four studies), followed by costs of medications (three studies), income (three studies), and disease-related knowledge (three studies). Distinctly from most of the studies selected, one of them evidenced suboptimal adherence in individuals receiving the medication free of charge, and another one could not find correlation between suboptimal adherence and educational level.

Conclusion Socioeconomic factors negatively impact medication adherence in PD patients. This review provides basis for developing patient and population-based interventions to improve adherence to treatment in PD.

Resumo

Antecedentes A adesão à medicação é um componente crucial no manejo correto da doença de Parkinson (DP) e, embora esteja bem estabelecido que o fator socioeconômico é uma barreira à adesão medicamentosa em muitas doenças crônicas, seus impactos na DP ainda precisam ser investigados.

Objetivo Explorar quais são e como os fatores socioeconômicos afetam a adesão à medicação em pessoas com DP.

Métodos Realizamos uma revisão de escopo em três bases de dados para identificar estudos que explorassem quais e como os fatores socioeconômicos impactam na adesão à medicação em pessoas com DP, considerando oito atributos: 1. nível educacional, 2. conhecimento relacionado à doença, 3. renda, 4. custo de medicamentos, 5. subsídio de medicamentos (ou seja, presença de subsídios no custo dos medicamentos), 6. empregabilidade e 7. etnia (negra, indígena, imigrantes).

Resultados Dos 399 estudos identificados (Embase = 294, Medline = 88, LILACS = 17), oito preencheram os critérios de inclusão. Identificamos fatores que abrangem os oito atributos de impacto socioeconômico e todos impactaram negativamente na adesão medicamentosa de pessoas com DP. Foram mais prevalentes o baixo nível educacional do paciente (quatro estudos), custos dos medicamentos, nível de renda e conhecimento relacionado à doença (três estudos cada). Diferentemente da maioria dos estudos selecionados, um deles evidenciou adesão subótima em indivíduos que receberam a medicação gratuitamente, e outro não encontrou correlação entre adesão subótima e nível educacional.

Conclusão Fatores socioeconômicos impactam negativamente a adesão ao tratamento medicamentoso em pessoas com DP. Esta revisão fornece base para o desenvolvimento de intervenções baseadas em pacientes e populações no intuito de melhorar a adesão ao tratamento farmacológico de pessoas com DP.

Keywords

Medication Adherence - Patient Compliance - Parkinson Disease - Socioeconomic Factors

Palavras-chave

Adesão à Medicação - Cooperação do Paciente - Tratamento da Doença de Parkinson - Fatores Socioeconômicos

Authors' Contributions:

GG: conceptualization, data curation, formal analysis, investigation, methodology, writing original draft, review and editing; MHST: data curation, visualization, writing - review and editing; HBF: conceptualization, data curation, investigation, methodology, project administration, supervision, validation, writing original draft.




Publication History

Received: 07 August 2023

Accepted: 31 October 2023

Article published online:
23 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Gustavo Gil, Michelle H. S. Tosin, Henrique Ballalai Ferraz. The impact of the socioeconomic factor on Parkinson's disease medication adherence: a scoping review. Arq Neuropsiquiatr 2024; 82: s00441779608.
DOI: 10.1055/s-0044-1779608
 

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