2012


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2012/№2

On the issue of a role of the social environment in increase of treatment compliance of elderly outpatients

Temnikova E. A.

Keywords: treatment compliance, social rehabilitation, old age, CHD

DOI: 10.18087/rhj.2012.2.1681

Relevance. Compliance of patients with prescribed therapy is an important treatment efficiency-influencing factor, which is why improvement of patient compliance is an urgent problem. Objective. Evaluation of influence on patients’ treatment compliance of the therapeutic training of social workers who take domiciliary care of elderly outpatients with CHD. Materials and methods. Comparative, randomized, open-label, parallel-group, prospective clinical study was carried out with elements of retrospective analysis of 130 elderly patients (average age 80.7±3.76 years) with diagnosis of CHD in the district clinics of Omsk. The following dynamic parameters were evaluated: medication compliance by Morisky-Green test, presence and intensity of CHD symptoms, FC, health related quality of life (QoL) of patients. Compared groups did not differ initially by intensity of symptoms and severity of disease, frequency of comorbidities and volume of medicamentous therapy. Results. In both groups low compliance to spent therapy is revealed. At comparison in a year are noted authentic reduction of expressiveness of symptoms and CHD FC, improvement QoL indices in the group supervised by the trained social workers, and absence of positive results in the control group. Besides, the intervention group had statistically less number of hospitalizations due to CHD decompensation. The main factor which defined such differences was considerable improvement of treatment compliance of patients supervised by the trained social workers. Conclusion. Therapeutic training of the social environment of elderly patients results in increase of patients’ treatment compliance and improves treatment results within a year of supervision.
  1. 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.
  2. Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002;288(4):462-467.
  3. Cramer J, Rosenheck R, Kirk G et al. Medication compliance feedback and monito ring in a clinical trial: predictors and outcomes. Value Health. 2003;6(5):566-573.
  4. Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. JAMA. 2002;288(22):2880-2883.
  5. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23(8):1296-310.
  6. Adherence to long-term therapies: evidence for action. Available at: http: www.who.int chp knowledge publications adherence_full_report.pdf
  7. McDonnell PJ, Jacobs MR. Hospital admissions resulting from preven­table adverse drug reactions. Ann Pharmacother. 2002;36(9):1331-1336.
  8. Senst BL, Achusim LE, Genest RP et al. Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm. 2001;58(12):1126-1132.
  9. Levy G, Zamacona MK, Jusko WJ. Developing compliance instructions for drug labeling. Clin Pharmacol Ther. 2000;68(6):586-591.
  10. Evangelista L, Doering LV, Dracup K et al. Compliance behaviors of elderly patients with advanced heart failure. J Cardiovasc Nurs. 2003;18(3):197-206; quiz 207-208.
  11. van der Wal MH, Jaarsma T. Adherence in heart failure in the elderly: problem and possible solutions. Int J Cardiol. 2008;125(2):203-208.
  12. McGann P.E. Comorbidity in heart failure in the elderly. Clin Geriatr Med. 2000;16(3):631-648.
  13. Ekman I, Fagerberg B, Skoog I. The clinical implications of cognitive impairment in elderly patients with chronic heart failure. J Cardiovasc Nurs. 2001;16(1):47-55.
  14. Vogels RL, Scheltens P, Schroeder-Tanka JM, Weinstein HC. Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail. 2007;9(5):440-449.
  15. Chin MH, Goldman L. Factors contributing to the hospitalization of patients with congestive heart failure. Am J Public Health. 1997;87(4):643-648.
  16. Krumholz HM, Butler J, Miller J et al. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation. 1998;97(10):958-964.
  17. Hoving C, Visser A, Mullen PD, van den Borne B. A history of patient education by health professionals in Europe and North America: from authority to shared decision making education. Patient Educ Couns. 2010;78(3):275-281.
  18. Phillips CO, Wright SM, Kern DE et al. A Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA. 2004;291(11):1358-1367.
  19. Evangelista LS, Shinnick MA. What do we know about adherence and self-care? J Cardiovasc Nurs. 2008;23(3):250-257.
  20. Swedberg K. What should we do about heart failure: challenges for 2009. Eur J Heart Fail. 2009;11(1):1-2.
  21. Гендлин Г.Е., Самсонова Е.В., Бухало О.В. и др. Методика исследования качества жизни у больных хронической недостаточностью кровообращения. Сердечная недостаточность. 2000;1(4)1-12.
  22. Hlatky MA, Boineau RE, Higginbotham MB et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989;64(10):651-654.
  23. Morisky DE, Green LW, Levine DM. Concurrent and predictive vali­dity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74.
Temnikova E. A. On the issue of a role of the social environment in increase of treatment compliance of elderly outpatients. Russian Heart Journal. 2012;11(2):72-77

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