Background: An assessment of the level of adherence of patients diagnosed with hypertension to therapy has not been conducted in Central Asia yet. It includes the lack the information on the impact of digital technologies on hypertension management. Objective: The study aimed at the evaluation of the effect of using a mobile application on adherence to therapy in patients with diagnosed arterial hypertension. Methods: A multi-centre randomized controlled study was conducted on 517 patients with diagnosed arterial hypertension (in the out-patient clinic, Almaty, Kazakhstan). Patients were randomly assigned to intervention (IG) and control (CG) groups. IG patients used a mobile application, which allowed creating an individual schedule for taking medications, including visual and audio notifications. The assessment of adherence to antihypertensive treatment was carried out using the Lebanese Medication Adherence Scale-14 (LMAS-14), consisting of 14 items. Data were collected before therapy (T1), 3 months (T2), 6 months (T3) and 12 months (T4) followed the first dose. Adherence was assessed on 101 patients in the CG group and 165 respondents in the IG group. Results: In the period T1 in both groups CG and IG, a moderate adherence to treatment was recorded with indices equal to 35.9 ± 1.2 and 35.9 ± 1.3, respectively (p ≤ 0.05). A decrease in adherence in the CG group was determined after 3 months (35.9 ± 1.2) (p ≤ 0.05) and six months later (36.5 ± 3.2) in comparison with relatively high adherence among respondents in the IG group in periods T2 (39.5 ± 1.2) and T3 (40.5 ± 1.2) (p ≤ 0.001). After 12 months (T4) on the adherence scale in patients who used the mobile application “MyTherapy” (IG), despite a slight decrease in scores, the results were relatively higher (40.3 ± 1.3) compared with the CG group (33.6 ± 1.9) (p ≤ 0.001). Conclusion: The analysis of adherence of patients with primary health care in Almaty (Kazakhstan) with chronic arterial hypertension showed the effectiveness of using the ‘MyTherapy’ mobile application in increasing patient adherence. The obtained data on the positive effect of the use of digital technologies require further research to assess the possibility of wider implementation in healthcare.

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In this cross-sectional study we assessed self-perceived quality of inpatient healthcare in three Kazakhstani cities. Altogether, 923 patients admitted to the city hospitals in Almaty, Aktobe and Semey filled out an anonymous questionnaire. 63 % of them were emergency patients. Binary logistic regression and principal component analysis (PCA) were used. Adjustments for social and demographic patients' characteristics were made. Altogether, 82.9 % (95 % CI 80.3-85.2) of patients rated the quality of healthcare as good or excellent. Among emergency patients, the key factors for being unsatisfied by the quality of services were insufficient quality of hospital food (OR 4.2; 95 % CI 1.70, 10.4), poor communication between doctors and nurses (OR 6.3; 95 % CI 2.3; 17.3) and the lack of adequate explanations regarding procedures and medication (OR 3.8; 95 % CI 1.5, 9.6). Among non-emergency patients, the key factors for being unsatisfied by the quality of services were insufficient quality of hospital food (OR 2.3; 95 % CI 1.2, 4.6), poor communication between doctors and nurses (OR 6.3; 95 % CI 2.9, 13.5), situation if the physician did not pay attention to whether a patient understood information about his/her condition or treatment (OR 2.4; 95 % CI 1.0, 5.2), when the patient has not had the opportunity to discuss his/her condition with medical staff (OR 2.7; 95 % CI 1.2, 5.8), if the patient's relatives was not given a possibility to communicate with a doctor (OR 4.3; 95 % CI 1.7, 11.0), or such this possibility was limited (OR 4.8; 95 % CI 1.9; 12.2).

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