Низкая приверженность терапии и пути ее преодоления на примере антиагрегантной терапии

Abstract

The article is focused on the issues of poor patient adherence to medication treatments, including antiplatelet drugs, its reasons, and solutions for overcoming compliance barriers. As of today, treatment adherence remains low leading to a higher risk of cardiovascular complications. Poor adherence to acetylsalicylic acid (ASA) treatment is mainly linked to a relatively frequent development of gastrointestinal side effects. The solutions for overcoming this problem include the use of lowest effective doses and the development of different acetylsalicylic acid (ASA) formulations: enteric coated and buffered. The efficacy and safety of these formulations are compared in the article. Buffered formulation (e.g. ASA + magnesium hydroxide) is similar to plain ASA as regards its antiplatelet activity and the prevalence of "aspirin- resistance", while its intake is associated with a lower risk of enteropathy and gastropathy as compared to plain and even enteric coated ASA. This is particularly important for patients with obesity and diabetes mellitus, as these conditions are associated with an affected rate of absorption from the small intestine. Based on the study findings a conclusion is made that buffered ASA should be the preferred formulation for use. The literature review is illustrated by a clinical case. KEYWORDS: chronic ischemic heart diseases, secondary prevention, adherence to therapy, acetylsalicylic acid, antiaggregant therapy, acetylsalicylic acid buffered and enteric coated formulations, aspirin-resistance. FOR CITATION: Ageev F.T., Smirnova M.D., Fofanova T.V. Poor patient adherence to medication treatments and solutions for overcoming compliance barriers as illustrated by antiplatelet therapy. Russian Medical Inquiry. 2023;7(1):56–61 (in Russ.). DOI: 10.32364/2587-6821- 2023-7-1-56-61.