Impacto da educação em saúde na adesão ao tratamento de doenças crônicas
DOI:
https://doi.org/10.5281/zenodo.18664948Palavras-chave:
Educação em Saúde, Adesão ao Tratamento, Doenças Crônicas, Literacia em SaúdeResumo
Introdução: As doenças crônicas não transmissíveis representam a principal carga de morbimortalidade global, com taxas de não adesão à farmacoterapia de longo prazo próximas a 50% nos países desenvolvidos, sendo a literacia em saúde um determinante central para a autogestão e adesão terapêutica. Objetivo: Sistematizar e analisar criticamente as evidências sobre o impacto da educação em saúde na adesão ao tratamento de doenças crônicas, examinando fundamentos teóricos, estratégias e modalidades empregadas, efetividade e desafios para implementação clínica. Metodologia: Revisão narrativa da literatura com busca na PubMed/MEDLINE utilizando descritores MeSH e termos textuais sobre educação em saúde, adesão e doenças crônicas. Foram identificados 3.862 artigos iniciais, refinados para 227 após aplicação de filtros para meta-análises, ensaios clínicos randomizados, revisões e revisões sistemáticas em humanos nos últimos 5 anos, com seleção baseada em aderência temática, qualidade metodológica e relevância. Resultados: A educação em saúde demonstra eficácia consistente na melhoria da adesão em diabetes, hipertensão, DPOC, insuficiência cardíaca e doença renal crônica. Intervenções com múltiplas estratégias, métodos interativos como teach-back, abordagens personalizadas e tecnologias digitais (telemedicina, aplicativos móveis, agentes conversacionais e modelos de linguagem) mostraram-se promissoras. Barreiras incluem literacia limitada, multimorbidade e restrições de recursos; facilitadores abrangem suporte social, programas estruturados e atuação de enfermeiros e farmacêuticos. Estima-se que 3.482 estudos foram analisados em revisão de escopo sobre barreiras e facilitadores. Conclusão: A educação em saúde é intervenção central e eficaz para adesão terapêutica, cujo êxito decorre de processo sistemático de avaliação do paciente, seleção de estratégias pedagógicas, monitoramento e ajuste dinâmico. Persistem heterogeneidade metodológica, escassez de estudos em países de baixa e média renda e defasagem entre inovação tecnológica e evidências de longo prazo. Recomendam-se ensaios pragmáticos, estudos de implementação, análises econômicas e métricas padronizadas.
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