The relationship and interinfluence of aspects of therapy safety and compliance in patients with cardiovascular diseases (by the data from outpatient registry “PROFILE”)

Abstract

Aim.To study the relationship and interinfluence of aspects of therapy safety and compliance in patients with chronic cardiovascular diseases (CVD) and their risk factors in the framework of outpatient prospective register “PROFIL”.Material and methods.The register method, enriched by two original questionnaires evaluating some safety pharmacotherapy guides and compliance, was used. We also practiced 8-item Morisky Medication Adherence Scale (MMAS-8) to assess overall compliance. The survey was undertook from September 1, 2017 to May 31, 2018. All together 167 of 177 people completed the questionnaires, 162 questionnaires of 80 women and 82 men were analyzed. The mean age of patients was 67,2±11,1 years. One hundred thirty participants answered all the questions of MMAS-8.Results.We determined that 46 (28,4%) of 162 patients had various adverse events (AE) of pharmacotherapy in history, half of patients (54,3) denied the presence of AE, other participants find difficult to answer this question. According to the data of original questionnaire, almost all patients (n=158, 97,5%) were given medical recommendations for taking medications. Also 145 (91,7%) of 158 patients noted that they were taking the prescribed drugs, but only 117 patients follow blindly recommendations, 13 people did not take drugs. According to the results of MMAS-8, 77 (59,2%) people did not follow recommendations, and 53 patients fully followed them. Regular visits to the attending physician and informing the patient by the doctor, including about AE, significantly increased overall compliance (p<0,05). No significant relationship was found between the number of drugs taken and AE. Patients who had no previous AE, rarely did not follow recommendations (13%), among patients with registered AE there were more cases of low compliance (27,5%, (p=0,044)). In patients who changed the dosage of medication on their own or cancel it, AE were observed more frequently (p<0,0001). The absence of AE in a patient fivefold increases the chances that he will follow recommendations — odds ratio: 5,2, 95% confidence interval: 1,2; 22,9 (p=0,028).Conclusion. Robust relationship and interinfluence of aspects of therapy safety and compliance, confirmed by the results of the study, determine advanced directions: optimizing the doctor-patient relationship, increasing patient awareness, rational drug use and etc. The lack of ways for obtaining of reliable and complete information about safety indicators and comliance in clinical practice is an important factor preventing the solution of the problem.

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

“…It is notable that in the outpatient cardiovascular registry "PROFILE" the researchers also measured medication adherence (n = 130) by MMAS-8 tool. The results revealed that 40.8% of patients had high adherence, 36.9% -moderate, and 22.3% -low (Lukina et al 2018). But the population was different in some variables, like age and medical history profile from the one described in this study.…”

“…Almost onethird of the participants felt hassled about sticking to their treatment regimens. The investigators of the "PROFILE" registry mentioned above reported 23.5% and 23.6% of the patients were prone to breaking the recommended treatment plan when feeling worse or better, respectively (Lukina et al 2018).…”

“…Another key factor of medication adherence is the quality of prescribed pharmacological treatment (Lukina et al 2017). Therefore, the next step was to compare the pharmacotherapy patterns of adherent and non-adherent coronary patients in regard with prescription rates of relevant medications (Table 2).…”

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?

“…Within the framework of the national CVD registry PROFIL, medication adherence was measured using the MMAS-8 (n = 130). 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).…”

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

“…Исследование было выполнено в рамках амбулаторного регистра «ПРОФИЛЬ» специализированного кардиологического подразделения научно-исследовательского центра [6,7]. Протокол «ПРОФИЛЬ» и все материалы, выдаваемые пациентам, включенным в регистр, были одобрены Независимым этическим комитетом Национального медицинского исследовательского центра профилактической медицины.…”