Assessment of Adherence to Treatment and Factors Affecting It in Patients With Stable Ischemic Heart Disease During Therapy With Nicorandil

Martsevich, S. Yu.; Lukina, Yu. V.; Кутишенко, Н. П.; Акимова, А. В.; Воронина, В. П.; Лерман, О. В.; Gaisenok, O. V.; Гомова, Т. А.; Ezhov, Andrey; Куимов, А. Д.; Либис, Р. А.; Matyushin, G. V.; Mitroshina, T. N.; Нечаева, Г. И.; Reznik, Ilya; Skibitsky, V. V.; Соколова, Л. А.; Чесникова, А. И.; Добрынина, Н. В.; Yаkushin, S. S.

doi:10.20996/1819-6446-2017-13-6-776-786

Cited by 6 publications

(7 citation statements)

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“…Как показали результаты других исследований, приверженность пациентов во многом зависит от информирования их лечащим врачом о заболевании и способах его лечения, в том числе возможностях лекарственной терапии при ожирении [8,9], однако в данном исследовании было обнаружено, что в отношении медикаментозной терапии ожирения существует немало проблем и со стороны врачей.…”

Section: Discussionunclassified

Medical treatment of obesity: peculiarities of medical treatments, information, responsibility and relation to medical treatment of obesity of patients

Лерман¹,

Лукина²,

Кутишенко³

et al. 2019

Klinicist

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The aim to evaluate medical appointments, as well as awareness, adherence and attitude of patients to medical treatment of obesity based on the results of a survey of patients with a prospective outpatient registry.Materials and methods. Total 305 patients with obesity in the outpatient “PROFILE” register were surveyed, including self-assessment questions regarding their own body weight, prescription of obesity treatment by doctors, patients’ adherence to the implementation of these recommendations, propensity to self-medication and information about personal financial costs for the treatment of this disease. 42 (12 %) patients refused to participate in the survey. 213 people (69.8 %) who answered the questionnaire were diagnosed with obesity of the 1st degree, 63 (20.7 %) – obesity of the 2nd degree; obesity grade 3 was detected in 29 people (9.5 %). Waist circumference in women averaged 104.7 ± 12.9 cm, in men – 116.7 ± 9.6 cm – all patients had abdominal obesity. 263 (86.2 %) people had arterial hypertension, 117 (38.4 %) patients had coronary heart disease; type 2 diabetes mellitus was diagnosed in every fourth patient (85 (27.2 %) people); atrial fibrillation was diagnosed in 55 (18 %) patients; 48 (15.7 %) people had a history of myocardial infarction, 23 (7.5 %) patients had a stroke.Results. According to the survey results, only one in four patients – 77 (25.2 %) – out of 305 patients who participated in the survey knew about the possibility of drug treatment of obesity. Mostly, patients received recommendations for non-drug treatment of obesity: 242 patients (79.3 %) were recommended to reduce caloric intake, 194 (63.6 %) – increased physical activity. Only 37 (12.1 %) patients with obesity were recommended for weight correction, significantly more often they were recommended and taken by patients with 2 and 3 degrees of obesity compared to patients with obesity of 1 degree (p <0.0001). At the time of the survey, none of the patients were taking drugs to treat obesity. Previous experience of drug weight loss had 42 (13.8 %) participants of the survey. Most patients (more than 70 %), in principle, are not ready to spend money on the fight against overweight, and drugs are considered an extra item of expenditure almost 90 % of obese patients. There is a significant relationship (p = 0.008) between the severity of the disease and patients’ spending on obesity treatment in the range of 1–5 thousand rubles per month: the higher the degree of obesity, the more patients agree to spend this amount on the treatment of the disease.Conclusion. According to the results of the survey, medical treatment of obesity is prescribed by doctors rarely. Apparently, this is due to the extremely low awareness of patients about the possibilities of drug therapy in the treatment of overweight and obesity, the popularity of biologically active additives independently used by patients to reduce weight.

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Section: Discussionunclassified

Medical treatment of obesity: peculiarities of medical treatments, information, responsibility and relation to medical treatment of obesity of patients

Лерман¹,

Лукина²,

Кутишенко³

et al. 2019

Klinicist

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“…Treatment Adherence and Quality of Life of Patients with Stable IHD Приверженность к лечению и качество жизни больных стабильной ИБС стенокардией напряжения, а также методы статисти-ческого анализа, подробно были изложены в преды-дущих публикациях [8][9][10].…”

Section: Discussionunclassified

“…В предыдущей работе, посвященной исследованию приверженности у пациентов наблюдательной про-граммы НИКЕЯ, было показано, что различные фак-торы, безусловно влияющие на КЖ больных стабильной ИБС, влияют на приверженность к лечению дополнительно назначенным препаратом никорандила [10]. Так, ведущей причиной отказа больных начать прием никорандила являлась полипрагмазия.…”

Section: Discussionunclassified

Treatment Adherence and Quality of Life of Patients With Stable Ischemic Heart Disease in Treatment With Nicorandil: Interrelation and Interaction (According to the Results of the Observational Study Nikea)

Martsevich

Lukina

Кутишенко

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To assess quality of life (QoL) and its dynamics during nicorandil treatment in patients with stable ischemic heart disease, to study the relationship of treatment adherence and QoL indicators when treated with nicorandil.Material and methods. Observational program NIKEA included 590 patients with angina pectoris. Seattle Angina Questionnaire (SAQ) was used to assess QoL. Patients completed SAQ at the visit of inclusion (V0) and at the visit after 3 months of observation (V3). Potential and actual adherence to therapy was assessed by medical interviews at visits V0, V1 (1 month of observation) and V3. During the visit V0 417 people (from 590 ones enrolled into the study) completed SAQ (71% response); after 3 months (V3) SAQ was filled in by 454 of 552 people who came to this visit (82% response). According to the results of medical interviews, potential adherence (visit V0) was determined in all 590 patients, actual adherence to nicorandil (visits V1 and V3) was assessed in 552 patients who came to these visits. In accordance with the degree of adherence, all patients were divided into 3 groups: (1) adherent to treatment (taking nicorandil for the first three months), (2) non-adherent (who refused to take nicorandil), and (3) partially non-adherent (who started nicorandil, but for various reasons stopped taking the drug).Results. In all patients, regardless of their adherence to the recommended drug, there was an increase in QoL according to all five scales of the SAQ after 3 months of follow-up. Statistically significant positive dynamics of all SAQ indicators was found only in adherent patients (p<0.0001 for all aspects). Patients, who showed good adherence to nicorandil at V1, had more severe angina at the beginning of treatment (according to “Angina Stability” and “Angina Frequency” indicators). These patients also had lower QoL “Disease Perception” score and more confidence in the doctor (“Treatment Satisfaction” score) than non-adherent patients (p<0.05). In non-adherent patients a mild degree of angina was determined 2 times more often according to “Angina Frequency” indicator (p=0.03).Conclusion. The results of the study confirm the interrelation and mutual influence of the QoL indicators and treatment adherence to nicorandil. Effective treatment with nicorandil in patients with lower health-related QoL indicators could increase treatment adherence. On the other hand, the mild degree of angina, the low level of confidence in the treating doctor, the side effects of the new drug reduce medication adherence of patients, which, as a result, negatively affects the QoL of these patients

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“…Дизайн проспективного многоцентрового наблюдательного исследования НИКЕЯ (изучение влияния дополнительной терапии НИКорандилом на тЕчение ишемической болезни сердца у пациентов со стабильной стенокардией напряжениЯ, получающих стандартную базовую терапию) был изложен в предыдущих публикациях [4,5].…”

Section: материал и методыunclassified

“…У 479 пациентов при телефонном опросе была определена приверженность к приему никорандила. Во время очных визитов исследования приверженность к лечению никорандилом диагностировалась с помощью оригинальной анкеты, включающей 4-вопросный тест Мориски-Грина [5]. При телефонном опросе оценивалась устойчивость к терапии (вариант приверженности, определяемый как продолжение терапии в течение рекомендованного периода времени) путем получения информации о приеме никорандила к моменту окончания наблюдения [6].…”

Section: материал и методыunclassified

The First Results of the Evaluation of Long-Term Nicorandil Treatment Effect on the Probability of Cardiovascular Complications in Patients with Stable Coronary Artery Disease (Data of Observational NIKEA Study)

Martsevich

Lukina

Кутишенко

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To assess the influence of addition of nicorandil on long-term cardiovascular complications in patients with chronic coronary artery disease (CAD) in the framework of a prospective observational study.Material and methods. Prospective observational multicenter NIKEA study included 590 patients with stable CAD. All patients were recommended to add nicorandil to their baseline therapy. After 21 months, 547 telephone contacts were made, the life status of 524 people was specified, 23 patients were lost to follow-up. The following complications were registered: death from any cause; non-fatal myocardial infarction (MI); non-fatal stroke; urgent myocardial revascularization; hospitalization due to deterioration of CAD, chronic heart failure (CHF) or atrial fibrillation (AF). In 479 patients, a telephone survey was performed to identify adherence (persistence) to nicorandil– i.e. to verify the continuing the treatment for the prescribed duration.Results. During the follow-up period, 15 deaths were recorded, the causes of which were as follows: 3 CAD (2 MI, 1 left ventricular aneurysm), 1 pulmonary embolism, 2 CHF; 1 stroke, 1 oncology, 1 bilateral pneumonia. In the remaining 6 cases, the causes of death were not known. Cardiovascular (CV) complications were MI (8 cases in 7 patients, 1 patient had 2 MI in the follow-up period, 3 patients from this group died), stroke in 6 patients (7 cases, 1 patient had 2 strokes, 1 patient died). Urgent percutaneous coronary intervention was performed in 3 patients (in 2 patients due to acute MI, in 1 patient due to unstable angina). During the observation period, 21 people were urgently hospitalized due to deterioration of clinical condition. According to the results of a medical survey, by the end of the follow-up period, 237 people were not adherent to prescribed nicorandil, and 242 patients took the recommended medication (adherent patients). The main cardiovascular complications and death from any cause (р<0.001) as well as the number of urgent hospitalizations (р=0.017) were significantly more common in non-adherent to nicorandil patients in comparison with adherent patients.Conclusion. The overall rate of CAD complications in NIKEA study was typical for patients with stable CAD receiving contemporary medical therapy. Addition of nicorandil significantly reduced the rate of CV complications in adherent patients in comparison with non-adherent patients.

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Assessment of Adherence to Treatment and Factors Affecting It in Patients With Stable Ischemic Heart Disease During Therapy With Nicorandil

Cited by 6 publications

References 0 publications

Medical treatment of obesity: peculiarities of medical treatments, information, responsibility and relation to medical treatment of obesity of patients

Medical treatment of obesity: peculiarities of medical treatments, information, responsibility and relation to medical treatment of obesity of patients

Treatment Adherence and Quality of Life of Patients With Stable Ischemic Heart Disease in Treatment With Nicorandil: Interrelation and Interaction (According to the Results of the Observational Study Nikea)

The First Results of the Evaluation of Long-Term Nicorandil Treatment Effect on the Probability of Cardiovascular Complications in Patients with Stable Coronary Artery Disease (Data of Observational NIKEA Study)

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