Adherence to Therapy in the Outpatient Setting: the Ability to Identify and Assess the Effectiveness of Therapy

Ageev, T.; Smirnova,; Деев, Д.; Fofanova, V T

doi:10.18087/cardio.2017.7.10004

Cited by 13 publications

(11 citation statements)

References 24 publications

(28 reference statements)

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“…The status of additional medication maintenance provided no better adherence. The study by Fofanova et al (2017) revealed no association either between the additional medication maintenance status and adherence in outpatients with arterial hypertension and CAD.…”

Section: Resultsmentioning

confidence: 80%

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Medication adherence in patients with stable coronary artery disease in primary care

Zyryanov¹,

Fitilev²,

Vozzhaev³

et al. 2020

RRP

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Introduction: Lack of research targeting non-adherence to cardiovascular medications in Russia prevents from developing effective interventions to improve adherence. The aim was to study medication adherence in patients with stable coronary artery disease in primary care. Material and methods: The study was conducted in a primary care setting of Moscow. Demography, medical history, pharmacotherapy data were obtained retrospectively from 386 coronary patients’ medical records. Medication adherence was measured by 8-item Morisky Medication Adherence Scale (MMAS-8). A statistical analysis was performed using SPSS Statistics V16.0. Results and discussion: According to the results from MMAS-8, 188 (48.7%) coronary patients had high medication adherence, 135 (35.0%) – moderate, and 63 (16.3%) – low. By the dichotomous interpretation: 48.7% (n = 188) – were adherent, 51.3% (n = 198) – were non-adherent. These groups were similar in gender distribution, age, and medical history profile (p > 0.1 for all variables). Smokers prevailed in the non-adherent group (13.6 vs. 5.3%; p = 0.009). Both groups were equally prescribed beta-blockers, antiplatelets, and statins (p > 0.1 for all). Use of fixed dose combinations (11.7 vs. 5.6%; p = 0.048) and the number of pills taken (mean 5.64 ± 1.52 vs. 5.99 ± 1.62; p = 0.029) were associated with better adherence. Higher values of total cholesterol (mean 5.2 ± 1.4 vs. 4.7 ± 1.2 mmol/L; p < 0.001) and low-density lipoprotein cholesterol (mean 2.9 ± 1.2 vs. 2.4 ± 0.9 mmol/L; p < 0.001) were revealed in non-adherents. Subjects with suboptimal adherence visited general practitioners more frequently (median 5 vs. 3 visits; p = 0,003). Conclusion: Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patient. Smoking and poorer control of blood lipids prevailed in non-adherents, who also caused higher load on general practitioners.

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Section: Resultsmentioning

confidence: 80%

“…According to that data, 61.1% of patients had poor medication adherence (≤ 3 points by 4-item Morisky scale). Yet, the target population was younger, and prevalence of CAD was less than 50% (Fofanova et al 2017).…”

Section: Resultsmentioning

confidence: 99%

Medication adherence in patients with stable coronary artery disease in primary care

Zyryanov¹,

Fitilev²,

Vozzhaev³

et al. 2020

RRP

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“…Only 40% of patients were adherent to treatment (Lukina et al 2018). Another study in patients with hypertension and SCAD examined in outpatient healthcare facilities of Moscow reported the level of non-adherence (3 points or less by 4-item MMAS) to prescribed drug therapies being at 61% (Fofanova et al 2017).…”

Section: Resultsmentioning

confidence: 99%

Critical aspects of the management of stable coronary artery disease in primary care practice or how to increase the efficacy of evidence-based pharmacological therapy?

Zyryanov¹,

Fitilev²,

Vozzhaev³

et al. 2020

RRP

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Introduction: The publication describes a fragment of the pharmacoepidemiologic study conducted to review the quality of management of patients with stable coronary artery disease (SCAD) in primary care over a 12-year period. The aim of the study was to justify the application of standard operating procedures (SOPs). Such determinants of pharmacotherapy as non-pharmacological modification of cardiovascular risk factors (RFs) and medication adherence were analyzed. Material and methods: A retrospective, cross-sectional, 3-stage (2006, 2011, 2018) study was conducted in a primary care setting of Moscow. As many as 3027, 1834, 805 patients with verified diagnosis of SCAD were included. Demographics, medical history, data on modifiable RFs and prescribed drug therapies were collected. At the third stage, medication adherence was measured, using the 8-item Morisky scale. Results and discussion: Over a 7-year period, better control of modifiable RFs in coronary patients was revealed. The target levels of blood pressure were reached in 58.3% (+20.7%; p < 0.05) of the patients, total cholesterol – in 33.0% (+16.0%; p < 0.05), and low-density lipoprotein cholesterol – in 23.3% (+12.2%; p < 0.05). Two critical problems that determined still inadequate RFs control were identified. The attention of physicians to RFs and rates of non-pharmacological interventions remained low throughout the study. Information on lifestyle RFs was recorded in fewer than one-third of the subjects. The lipid profile was registered only in half of patients’ histories. Non-adherence to pharmacotherapy was identified in 51.3% of patients. Conclusion: Further increase in efficacy of pharmacotherapy might be provided by application of SOPs regarding the registration and correction of modifiable cardiovascular RFs, identification of non-adherent patients and promotion of medication adherence.

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“…Считается, что одним из важных моментов, усиливающих приверженность пациентов к терапии, является самоконтроль АД. Результаты российских исследований также доказывают, что регулярный самоконтроль АД в домашних условиях значительно повышает приверженность пациентов к лечению [8], по результатам скрининга МММ19 в России лишь треть пациентов высокого риска измеряли АД в течение последних 12 мес. Более склонны к регулярному приему гипотензивных средств пациенты с осложненной АГ, особенно имеющие в анамнезе ССО, что соответствует полученным нами данным.…”

Section: таблицаunclassified

May Measurement Month 2019: adherence to treatment and hypertension control in Russia

et al. 2020

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Международное общество по артериальной гипертензии и Мировая антигипертензивная лига организовали скрининговое исследование по измерению артериального давления (АД) под названием MMM19 -MAY MEASUREMENT MONTH 2019 для улучшения выявления повышенного АД и оценки контроля АД у пациентов с артериальной гипертензией (АГ). Цель. Определить приверженность к лечению российского населения по результатам скрининга АГ в рамках международной акции МММ19. Материал и методы. В течение мая 2019г в скрининге приняли участие 5394 человека из 21 региона России. Участие в акции было добровольным без ограничения по полу, возраст старше 18 лет. Во время скрининга трехкратно измерялось АД с помощью автоматических и механических тонометров, заполнялся опросник о наличии сахарного диабета, сердечно-сосудистых осложнений в анамнезе, курении и употреблении алкоголя. Также получена информация о дате последнего контроля АД и приеме статинов, ацетилсалициловой кислоты и антигипертензивных препаратов. Информация о росте и массе тела была получена со слов респондентов. Результаты. В анализ были включены данные 5274 пациентов в возрасте от 18 до 96 лет, из них 1834 мужчин (34,8%). Медиана возраста -25 лет, квартили -20 и 49 лет. Пропорция пациентов с АГ по результатам МММ19 в российской выборке составила 31,9%, а при исключении участников младше 25 лет -51,5%. Пациенты с АГ старше 25 лет принимают антигипертензивную терапию (АГТ) в 73,6%, при этом 38,6% пропускают прием препаратов, а достигают целевого уровня АД <130/80 мм рт.ст. только 11,8% мужчин и 17,2% женщин. Даже при использовании 4-5 антигипертензивных препаратов, только 20-30% участников акции достигали целевого уровня АД. Заключение. По результатам скрининга МММ19 в России лишь треть пациентов высокого риска измеряли АД в течение последних 12 мес., наблюдается низкая приверженность к приему АГТ и недостаточный контроль АГ. Более склонны к регулярному приему гипотензивных средств пациенты с АГ, имеющие в анамнезе сердечно-сосудистые осложнения.Ключевые слова: скрининг, артериальная гипертензия, артериальное давление, приверженность, осведомленность. Отношения и деятельность: нет.

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Adherence to Therapy in the Outpatient Setting: the Ability to Identify and Assess the Effectiveness of Therapy

Cited by 13 publications

References 24 publications

Medication adherence in patients with stable coronary artery disease in primary care

Medication adherence in patients with stable coronary artery disease in primary care

Critical aspects of the management of stable coronary artery disease in primary care practice or how to increase the efficacy of evidence-based pharmacological therapy?

May Measurement Month 2019: adherence to treatment and hypertension control in Russia

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