Arterial hypertension treatment changes in Yaroslavl region: results obtained after 4 years of complex program of regional healthcare system’s improvement implementation

Abstract

Program’s aim. Cardiovascular morbidity and mortality rates in Russia are among the highest in Europe. The aim of this work was to implement a complex healthcare system improvement program in Russia’s Yaroslavl region, dedicated to increasing arterial hypertension treatment efficacy and prevent complications of arterial hypertension. Materials and methods. The program was developed by a group of healthcare professionals of the Department of Healthcare and Pharmacy of Yaroslavl region together with Novartis Pharma Company’s technical advice within the framework of a private-public partnership. The program consisted of several actions aiming to raise the healthcare system’s attention to hypertension. Achievement of target blood pressure (BP) control by every patient seen by physicians of the Yaroslavl region healthcare system became the main goal and leading criteria for assessing hypertension treatment efficacy. Additionally, significant effort was put into patient education on self-control of BP levels and importance of achieving target BP levels in accordance with Russian national clinical guidelines and on adherence to treatment. Within 4 years, program efficacy was evaluated and reinforced by conducting annual cross-sectional questionnaire-based epidemiological studies. Analysis was performed in a representative sample of patients that evaluated BP control level, mean BP levels, systolic BP level distribution by grades, as well as cardiovascular risk factors and concomitant diseases presence and current antihypertensive therapy. In addition, analysis of official statistics on disease incidence and drug sales databases were performed. Results. From 2011 to 2014 BP control level increased significantly: 17% of patients had BP