Compliance of patients with cardiovascular diseases to optimal drug therapy

Abstract

Introduction. An important principle of improving cardiovascular care is to increase the compliance of patients to optimal drug therapy. Purpose. To identify compliance in patients with cardiovascular diseases to optimal drug therapy. Materials and methods. Direct continuous questioning of patients with cardiovascular diseases (n = 1,018) was carried out using a modified Morisky D. questionnaire (1986). The survey was carried out by cardiovascular surgeons (n = 3) of the Central Clinical Hospital "Russian Railways Medicine". The degree of adherence of patients to the implementation of the recommendations of doctors at the stage of the initial interview and in 6 and 24 months was compared (p < 0.05). Results. At the stage of the first consultation low compliance of patients to antihypertensive therapy (23.8%); high compliance to dual antiplatelet therapy was established in patients after endovascular arterials stenting (99%), anticoagulant therapy in patients with atrial fibrillation (86%) and hypoglycemic therapy in patients with diabetes (98%). After follow-up for six months, including the provision of endovascular and surgical care, compliance to optimal drug therapy in patients of all groups increased up to 99.9% (p < 0.05). After follow-up for 24 months, the compliance degree to antihypertensive and anticoagulant therapy slightly decreased to 93.8 and 97.5%, respectively (p > 0.05). Limitations. To assess compliance to the recommendations of doctors, the results of outpatient follow-up of one thousand eighteen patients with cardiovascular diseases over two years were analyzed, which is a sufficient reference sample. Conclusion. Compared with the initial consultation of patients, their compliance to optimal drug therapy increased during the 12 months of follow-up. Clinical management in the treatment-and-prophylactic process optimizes control over the effectiveness of the implementation of medical prescriptions, including self-control by patients of hemodynamic and other indicators. The formation of trusting relationships in the “doctor-patient” system is the most important principle of the continuity compliance of clinical management of the process of improving public health.