Use of technical methods to influence treatment compliance of cardiac patients in the outpatient practice. 12‑month monitoring results
Ageev F. T., Fofanova T. V., Smirnova M. D., Tkhostov A. Sh., Nelyubina A. S., Kuzmin A. G., Galaninskiy P. V., Kadushina E. B., Nuraliev E. Yu., Kheimets G. I.
Keywords: treatment compliance, cardiac diseases
Relevance. Patients’ treatment compliance is one of the burning healthcare problems of the day. Objective. Possible application of the technical methods of influence on CD patients’ treatment compliance in outpatient / polyclinic practice was studied. Materials and methods. The study included patients with moderate / low risk of the development of atherosclerosis complications (Group 1), patients without history of CHD, but with high and very high risk of the development of atherosclerosis complications (Group 2), and CHD patients (Group 3). At the initial stage, each group had been divided into subgroups A and B. Treatment compliance enhancement techniques (automated telephone calls with a differentiated reminder text, intensifying medical control of drug intake by means of a self-monitoring diary, and risk factors correction and life style change guidelines) were used in subgroup A. The data of 919 patients from active supervision group, 663 of which gave their consent to auto-calls, were analyzed. Results. At the end of the year, treatment compliance was significantly higher in the whole cohort. Treatment compliance in CHD patients initially had been significantly higher than in patients with low / moderate and high / very high risks. Use of auto-call technique in the CHD group allowed to enhance significantly patients’ treatment compliance. In the groups with low / moderate and high / very high risks of cardiovascular complications, compliance enhancement was registered both in the auto-call and in refusal groups. However, auto-call patients with low / moderate and high / very high of cardiovascular complications showed significantly lower levels of cholesterol and LDL, higher HDL levels, and lower pulse-wave velocity (PWV) in comparison with the refusal group. Conclusion. The use of auto-call technique enhances significantly treatment compliance of CHD patients. The use of auto-call technique allowed to reduce significantly PWV values and cholesterol, LDL and triglyceride levels, and to increase HDL levels in RF patients without CHD.
- Simpson SH, Eurich DT, Majumdar SR et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333 (7557):15.
- World Health Organisation (2003): Adherence to long_term therapies, evidence for action. Available at: http://www.who.int / chp / knowledge / publications / adherence_report / en /
- Агеев Ф. Т., Фофанова Т. В., Дробижев М. Б. и др. Свободная или фиксированная комбинация эналаприла и гидрохлортиазида в реальной амбулаторной практике: что лучше для больного артериальной гипертонией? Сравнение эффективности и приверженности к лечению. Кардиология. 2008;48 (5):10–15.
- Агеев Ф. Т., Фофанова Т. В. Длительное амбулаторное наблюдение за пациентами с артериальной гипертонией. – Пособие для врачей. Москва, – 2004 г.
- Нелюбина А. С. Роль обыденных представлений в формировании внутренней картины болезни: дис. … канд. психол. наук. – М.: МГУ, 2009. – 243 с.
- Morisky DE, Green LW, Levine DM. Concurent and predictive validity of self-reported measure of medical adherence. Med Care. 1986;24 (1):67–74.
- Atreja A, Bellam N, Levy SR. Strategies to Enhance Patient Adherence: Making it Simple. Medscape General Medicine. 2005;7 (1):4–9.
Ageev F. T., Fofanova T.V., Smirnova M.D. et al. Use of technical methods to influence treatment compliance of cardiac patients in the outpatient practice. 12‑month monitoring results. Russian Heart Journal. 2012;11(2):67-71