Principais fatores associados ao abandono terapêutico da tuberculose no âmbito da atenção primária: uma revisão integrativa

Abstract

Introduction: Tuberculosis is one of the main infectious and contagious diseases with high prevalence and great impact on morbidity and mortality, mainly in developing countries like Brazil. Despite the existence of effective treatment, the rate of therapeutic abandonment in our country (12%) is far above what is acceptable by the World Health Organization (5%), in this context, primary care is a very important tool to identify which factors involved in dropout and reach these patients with individualized strategies. Objective: To identify in recent literature the main factors involved in abandoning tuberculosis treatment in primary care. Methods: This is an integrative literature review, descriptive research, qualitative approach and deductive method carried out from the electronic databases: Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information (BIREME), Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Electronic Library Online (SciELO) and Google Scholar using the descriptors and their correspondents in English “attention primary/primary health care”, “tuberculosis/tuberculosis” and “compliance to medication/medication adherence”, with the Boolean operators “e/AND”. Results: The initial search returned 279 articles divided as follows Scielo(4), Bireme(20), Lilacs(7), Scopus (95), Web of Science (53) and Google Scholar (100), after reading in full and applying of the inclusion and exclusion criteria, 22 works were selected to compose the sample of this study. The main factors associated with therapeutic abandonment were: male gender, young individual, non-white, low education, low income, homeless individual, alcohol abuse, smoking, consumption of illicit drugs, presence of comorbidities, prolonged treatment time , adverse drug reactions, difficult access to health services, failure in the referral and counter-referral system, deficit of human resources in health units. On the other hand, family support, a good doctor-patient relationship, and individuals who were well informed about their disease and treatment were associated with a higher rate of treatment completion. Conclusions: Therapeutic abandonment has a multifactorial nature, therefore, it is necessary for primary care professionals to have a comprehensive view in the care of patients with tuberculosis.