Determinantes y estrategias de adherencia a terapia inhalada en adultos con Asma bronquial
Determinants and adherence strategies to inhaled therapy in adults with Bronchial AsthmaBarra lateral del artículo
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El asma bronquial constituye una patología inflamatoria crónica de las vías respiratorias. Objetivo: Analizar la evidencia científica reciente (2023-2025) sobre determinantes, métodos de medición e intervenciones en la adherencia a la terapia inhalada en adultos con asma. Metodología: Se realizó una revisión sistemática siguiendo las directrices PRISMA 2020. Se consultaron PubMed, Scopus y Web of Science identificando estudios publicados desde enero 2023. Treinta investigaciones cumplieron los criterios de inclusión tras evaluación rigurosa. Resultados: Se evidenció una discrepancia sistemática entre la medición objetiva y subjetiva de adherencia, con sobreestimación del auto-reporte entre 13.6% y 57%. Los determinantes psicosociales emergentes incluyeron ansiedad (β=-0.34), depresión (β=-0.36) y miedo a efectos secundarios como predictores significativos de no-adherencia. Las intervenciones digitales mostraron eficacia inicial pero fatiga tecnológica a largo plazo. Se identificaron disparidades entre países de altos ingresos (problemas de fatiga digital) versus países de ingresos bajos-medios (barreras técnicas y de acceso). Conclusión: La adherencia permanece subóptima, requiriéndose monitoreo objetivo, tamizaje de salud mental integrado y personalización de intervenciones según contexto socioeconómico.
Bronchial asthma is a chronic inflammatory pathology of the airways. Objective: To analyze of recent scientific evidence (2023-2025) on determinants, measurement methods, and interventions for inhaled therapy adherence in adults with Bronchial Asthma. Methodology: A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science databases were searched for studies published since January 2023. Thirty investigations met inclusion criteria after rigorous evaluation. Results: A systematic discrepancy between objective and subjective adherence measurement was evidenced, with self-report overestimation ranging from 13.6% to 57%. Emerging psychosocial determinants included anxiety (β=-0.34), depression (β=-0.36), and fear of side effects as significant predictors of non-adherence. Digital interventions showed initial efficacy but long-term technological fatigue. Disparities were identified between high-income countries (digital fatigue issues) versus low-middle income countries (technical and access barriers). Conclusion: Adherence remains suboptimal, requiring objective monitoring, integrated mental health screening, and personalized interventions according to socioeconomic context.
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