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.