Treatment compliance of patients with paracoccidioidomycosis in Central-West Brazil

• Published in: Jornal brasileiro de pneumologia Vol. 45; no. 2; p. e20180167
• Main Authors: Andrade, Ursulla Vilella, Oliveira, Sandra Maria do Valle Leone de, Chang, Marilene Rodrigues, Pereira, Edy Firmina, Marques, Ana Paula da Costa, Carvalho, Lidia Raquel de, Mendes, Rinaldo Poncio, Paniago, Anamaria Mello Miranda
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Pneumologia e Tisiologia 18.04.2019
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents - therapeutic use; Brazil; Child; Child, Preschool; Female; Follow-Up Studies; Humans; loss to follow-up; Male; Medication Adherence - statistics & numerical data; Middle Aged; mycoses; Original; Paracoccidioidomycosis; Paracoccidioidomycosis - drug therapy; Prospective Studies; RESPIRATORY SYSTEM; Time Factors; Treatment adherence and compliance; Treatment Outcome; Young Adult; Brazil; mycoses; micoses; Cooperação e adesão ao tratamento; loss to follow-up; Paracoccidioidomycosis; Treatment adherence and compliance; Paracoccidioidomicose; perda de seguimento
• ISSN: 1806-3713; 1806-3756; 1806-3756
• DOI: 10.1590/1806-3713/e20180167

To evaluate the treatment compliance of patients with paracoccidioidomycosis. We studied 188 patients with paracoccidioidomycosis admitted to a tertiary referral hospital in the Central-West Region of Brazil from 2000 to 2010, to assess their compliance to treatment. In order to be considered compliant, patients needed to present two established criteria: (1) receive medicines from the pharmacy, and (2) achieve a self-reported utilization of at least 80% of the dispensed antifungal compounds prescribed since their previous appointment. Most patients were male (95.7%), had the chronic form of the disease (94.2%), and were treated with cotrimoxazole (86.2%). Only 44.6% of patients were treatment compliant. The highest loss to follow-up was observed in the first 4 months of treatment (p < 0.02). Treatment compliance was higher for patients with than for those without pulmonary involvement (OR: 2.986; 95%CI 1.351-6.599), and higher for patients with than without tuberculosis as co-morbidity (OR: 2.763; 95%CI 1.004-7.604). Compliance to paracoccidioidomycosis treatment was low, and the period with the highest loss to follow-up corresponds to the first four months. Pulmonary paracoccidioidal involvement or tuberculosis comorbidity predicts a higher compliance to paracoccidioidomycosis therapy.