Aim.To estimate the effectiveness of lipid-lowering therapy (LLT) at outpatient and hospital treatment stages in patients at high and very high cardiovascular risk during [2011][2012][2013][2014][2015]. Material and methods. In a cross-sectional epidemiological study we analyzed LLT in hospital patients for the period April-May 2011, 2012 All data were obtained from randomly selected case-records of patients (n=548; 20% of all hospital patients over the study period). Risk categories of patients as well as target levels of low density lipoprotein (LDL) cholesterol were determined according to the current clinical guidelines for the respective year. Outpatient LLT was administered in local out-patient clinics and hospital one -in the clinic of State Research Centre for Preventive Medicine. Results. The most commonly prescribed group of lipid-lowering drugs was statins, while combined treatment or monotherapy with other lipid-lowering agents were used only in rare cases. From 2011 to 2015 the proportion of patients taking statins before admission increased from 20% to 49.8% (from 23.1% up to 29.6% of patients at high cardiovascular risk and from 28% up to 68.5% of patients at very high cardiovascular risk, respectively). During hospitalization the proportion of individuals receiving statins increased from 49.8% to 72.9%, from 29.6% to 74% and from 68.5% to 95.3% in general group, among patients at high and very high cardiovascular risk, respectively. In 2015 LDL cholesterol target levels were achieved in 14.8% and 7.1% of patients at high and very high risk, respectively. In-hospital rate of simvastatin administration reduced from 33.6% to 0.5%, whereas prescription of atorvastatin and rosuvastatin increased from 31.4% to 64.5% and from 3.6% to 9.9%, respectively. Average dose of statins (in conversion to atorvastatin) increased from 10 mg to 20 mg in high-risk patients and from 10 mg to 40 mg -in very high risk group. Conclusion. Positive trend in frequency of LLT prescription was demonstrated in patients at high and very high cardiovascular risk during 2011-2015. Nevertheless, significant number of patients in out-patient clinics still remains under non-optimal treatment.Keywords: low-density lipoprotein cholesterol, cardiovascular risk, lipid-lowering therapy, atorvastatin, simvastatin, rosuvastatin, ezetemib. Цель. Изучить эффективность гиполипидемической терапии на амбулаторном и госпитальном этапах у пациентов высокого и очень высо-кого сердечно-сосудистого риска за период 2011-2015 гг. Материал и методы. В кросс-секционном эпидемиологическом исследовании проведен анализ гиполипидемической терапии за период апрель-май 2011, 2012 и 2015 гг. у пациентов стационара. Все данные были получены из случайно отобранных историй болезни пациен-тов, которые находились на госпитализации за указанный период (n=548; 20% от всех госпитализированных за изучаемый период). Кате-гории риска пациентов, а также целевые уровни холестерина липопротеидов низкой плотности (ХС ЛПНП) определялись согласно актуаль-ным клиническим рекоме...
The article provides an overview of foreign and national studies of socio-demographic factors of patients' commitment to treatment in atrial fibrillation and other chronic diseases. Low adherence to treatment with long-term therapy is the main reason for the decline in treatment effectiveness. Socio-demographic predictors of commitment to treatment, such as gender, age, race, marital status, education and income, are considered. Analysis of the results of studies shows the ambiguity and frequently contradictory connection of these factors with the commitment to treatment. At the same time, adherence to treatment is studied in connection with individual-personal factors - personality traits, level of emotional intelligence, self-efficacy, motivational features. It is suggested that individual-personal and general socio-demographic factors interact and have an indirect effect on adherence to treatment in long-term therapy.
Эмпирическое исследование посвящено субъективным представлениям о заболевании пациентов с фибрилляцией предсердий (ФП) и их приверженности антикоагулянтной терапии (АКТ). В структуре представлений предложено выделять факторы информированности о заболевании, неопределенности его проявлений, непредсказуемости течения, возможности контроля течения, для измерения которых предложен оригинальный опросник. Выявлено, что приверженность АКТ положительно связана с информированностью, отрицательно – с представлением о неопределенности симптоматики.
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