IMPLEMENTATION OF PATIENT-CENTERED MEDICAL CARE MODEL: ANALYSIS OF THE ATTITUDES OF PATIENTS WITH CORONARY ARTERY DISEASE AND COMORBIDITIES

Abstract

The aim: to evaluate the attitude of patients with coronary artery disease and comorbidities to the implementation of patient-centered care in clinical practice.
 Materials and methods. We carried out questionnaire survey of two groups of patients with coronary artery disease and comorbidities. The first one consisted of 30 patients with coronary artery disease aged 61-75 (mean age 67,2±5,1 years) who were followed by the cardiologist in the therapeutic department of the State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. The second one – 33 military personnel with coronary artery disease aged 50-58 years (mean age 53,2±2,4 years) who came for a scheduled appointment with a general practitioner at the Outpatient Care Clinic of the National military medical clinical center “GVKG”. Methods: system analysis, questionnaire survey, statistical.
 Results. According to patient`s opinion cardiologists give much more information about pharmacological treatment, including side effects of medications used (83,3±6,8% in the Ist group vs 33,3±8,2% in the 2nd group, p<0,05) and actions to increase patients` compliance (83,3±6,8% in the Ist group vs 42,4± 8,6% in the 2nd group, p<0,05). This is related to the peculiarities of management of patients with chronic diseases in the State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, in particular, with the follow-up of high-risk cardiac patients, including scheduled appointments and monitoring of patient`s clinical conditions by a cardiologist. Emotional support was given to 93,3±4,6% of patients in the Ist group and to 18,2±6,7% of patients in the 2nd group (p<0,05). 36,7±8,8% of patients in the Ist group and 84,8±6,3% in the 2nd group ( p<0,05) indicated, that they need more information about their treatment plan and involvement in clinical decision-making. 93,3±4,6% of patients in the Ist group and 4,8±6,3 % in the 2nd group were ready to perform self-monitoring of their health conditions and participate in the decision-making process regarding their treatment.
 Conclusions. Our survey demonstrated, that the majority of interviewed patients with coronary artery disease and comorbidities are ready to use basic principles of patient-centered care. The necessity to improve patient`s information and education about clinical decision-making and physician`s practical skills in the field of implementation of patient-centered care was substantiated.