Pharmacotherapy Quality in Patients With Arterial Hypertension Observed in Primary Care Practice. Hypertension Register Data

Posnenkova, Olga M.; Kiselev, Anton R.; Gridnev, Vladimir I.; Shvartz, Vladimir A.; Dovgalevsky, Pavel Ya.; Oschepkova, E.

doi:10.20996/1819-6446-2011-7-6-725-732

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Of note, although US and UK guidelines do not include beta blockers as first-line treatment for uncomplicated hypertension [5,6], Russian [4,7,8], and European [9,10] guidelines consider them one of the five major treatment classes for first-line treatment of hypertension.…”

Section: Resultsmentioning

confidence: 99%

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A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

Mozheyko

Eregin²,

Vigdorchik³

et al. 2012

Adv Therapy

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Section: Resultsmentioning

confidence: 99%

“…According to the latest reports from the 10-year Actions at the rst patient's visit, % All physician's primary patients (n = 138) GPs' primary patients (n = 89) Cardiologists' primary patients (n = 49) Hypertension Guidelines [7,8].…”

Section: Discussionmentioning

confidence: 99%

A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

Mozheyko

Eregin²,

Vigdorchik³

et al. 2012

Adv Therapy

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“…Other baseline characteristics of the Russian population including age distribution, gender distribution, and smoking status were controlled for. Baseline values for age, smoking status, prevalence of hypertension, and BP level and distribution in the hypertensive population were estimated using multiple sources [2] , [7] , [27] – [29] and imputed from the Model-based population. The Model was updated and adapted based on a recent model simulation of clinical outcomes in the Yaroslavl region of Russia (unpublished data, Archimedes/Novartis: white paper on model simulation).…”

Section: Methodsmentioning

confidence: 99%

Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia

Shum¹,

Alperin²,

Шальнова

et al. 2014

PLoS ONE

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ObjectivesRussia faces a high burden of cardiovascular disease. Prevalence of all cardiovascular risk factors, especially hypertension, is high. Elevated blood pressure is generally poorly controlled and medication usage is suboptimal. With a disease-model simulation, we forecast how various treatment programs aimed at increasing blood pressure control would affect cardiovascular outcomes. In addition, we investigated what additional benefit adding lipid control and smoking cessation to blood pressure control would generate in terms of reduced cardiovascular events. Finally, we estimated the direct health care costs saved by treating fewer cardiovascular events.MethodsThe Archimedes Model, a detailed computer model of human physiology, disease progression, and health care delivery was adapted to the Russian setting. Intervention scenarios of achieving systolic blood pressure control rates (defined as systolic blood pressure <140 mmHg) of 40% and 60% were simulated by modifying adherence rates of an antihypertensive medication combination and compared with current care (23.9% blood pressure control rate). Outcomes of major adverse cardiovascular events; cerebrovascular event (stroke), myocardial infarction, and cardiovascular death over a 10-year time horizon were reported. Direct health care costs of strokes and myocardial infarctions were derived from official Russian statistics and tariff lists.ResultsTo achieve systolic blood pressure control rates of 40% and 60%, adherence rates to the antihypertensive treatment program were 29.4% and 65.9%. Cardiovascular death relative risk reductions were 13.2%, and 29.6%, respectively. For the current estimated 43,855,000-person Russian hypertensive population, each control-rate scenario resulted in an absolute reduction of 1.0 million and 2.4 million cardiovascular deaths, and a reduction of 1.2 million and 2.7 million stroke/myocardial infarction diagnoses, respectively. Averted direct costs from current care levels ($7.6 billion [in United States dollars]) were $1.1 billion and $2.6 billion, respectively.

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“…На сегодняшний день существует обширная база доказательств по лечению больных АГ, которая нашла отражение в клинических рекомендациях. Несмотря на это эффективность медицинской помощи, особенно в первичном звене здравоохранения, остается неоптимальной [1,2]. Чтобы обеспечить достижение наилучших результатов у пациентов с АГ, необходимо регулярно контролировать их лечение и принимать оперативные решения по устранению отклонений от клинических рекомендаций.…”

Section: Introductionunclassified

Potential of a registry in evaluation of treatment of patients with essential hypertension in primary care (using the example of polyclinic located in Saratov region)

Gerasimov¹,

Alexandrova²

2015

Cardio-IT

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Резюме Цель -оценить качество лечения больных артериальной гипертензией (АГ) в поликлинике рабочего поселка Саратовской области с помощью информационно-аналитической системы регистра. Материал и методы -Ретроспективно изучены данные амбулаторных карт 88 пациентов с АГ (средний возраст 64,6±11,3 года; 40,5% мужчин), которые обратились за консультацией к участковому терапевту, врачу общей практики или кардиологу во время одного случайно выбранного приема. Для анализа качества лечения у больных АГ использовалась компьютерная информационно-аналитическая система (ИАС) Регистра пациентов с АГ, ишемической болезнью сердца (ИБС) и хронической сердечной недостаточностью (ХСН), которая оценивает исполнение клинических рекомендаций. Результаты -В группе исследования динамическое наблюдение проводилось согласно рекомендациям: все пациенты посетили поликлинику не менее 4 раз в течение последнего года. 42% больных АГ получали комбинированную антигипертензивную терапию. Однако около трети пациентов с неконтролируемым артериальным давлением (АД) продолжали оставаться на монотерапии. При сочетании АГ и ИБС антиагреганты были назначены в 82% случаев, статины -в 60% случаев, бета-блокаторы -в 80% случаев. При АГ в сочетании с ХСН были назначены ингибиторы ангиотензинпревращающего фермента или антагонисты рецепторов ангиотензина (иАПФ/АРА) в 87% случаев, при сочетании АГ и фибрилляции предсердий непрямые антикоагулянты были назначены в 62% случаев. Целевое АД достигнуто у 51% пациентов. Выводы -Применение ИАС Регистра АГ, ИБС и ХСН в первичном звене позволило объективно оценить исполнение клинических рекомендаций по лечению больных АГ. Установлено, что недостаточно часто назначается комбинированная антигипертензивная терапия, а также отдельные рекомендованные группы препаратов при наличии ассоциированных клинических состояний: статины при сочетании АГ и ИБС, антикоагулянты при фибрилляции предсердий. Целевое АД было достигнуто лишь у половины больных АГ.Ключевые слова: артериальная гипертензия, регистр, качество лечения, клинические рекомендации Abstract Aim -to evaluate the quality of treatment among hypertensive patients in workers settlement of Saratovskaya oblast using an research and information system of a registry.Material and Methods -Ambulatory cards of 88 patients with essential hypertension (aged 64.6±11.3 years, males -40.5%) who visited therapist, general practitioner or cardiologist during one randomly selected day were analyzed retrospectively. To assess the treatment quality we used computer research and informal system of hypertension (Htn), coronary artery disease (CAD) and chronic heart failure (CHF) registry. The registry controls a performance of hypertension guidelines in Htn patients.Results -Patients in the studied group were followed-up according to the guidelines. All patients visited polyclinic no less then four times during the previous year. 42% of patients were administered two or more antihypertensive drugs. However, about one third of hypertensives with uncontrolled blood pressure continued monothera...

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Pharmacotherapy Quality in Patients With Arterial Hypertension Observed in Primary Care Practice. Hypertension Register Data

Cited by 4 publications

References 12 publications

A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

A Cross-sectional Survey of Hypertension Diagnosis and Treatment Practices Among Physicians in Yaroslavl Region, Russia

Simulating the Impact of Improved Cardiovascular Risk Interventions on Clinical and Economic Outcomes in Russia

Potential of a registry in evaluation of treatment of patients with essential hypertension in primary care (using the example of polyclinic located in Saratov region)

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