COMPLIANCE TO CLINICIAN PRESCRIPTIONS IN ISCHEMIC HEART DISEASE PATIENTS (BY THE DATA FROM OUTPATIENT REGISTRY PROFILE)

Workgroup of the PROFILE registry: Voronina V. P., Dmitrieva N. A., Zakharova A. V., Zagrebelny A. V., Kutishenko N. P., Lerman O. V., Lukina Yu. V., Martsevich S. Yu., Tolpygina S. N.

Aim.  Based   on  the  data   of  outpatient   registry  PROFILE, with  addition  of questionnaires,  to  analyze  treatment  compliance   and  influencing  factors,   in coronary heart disease (CHD) patients.

Material and methods. 688 patients  of the PROFILE registry who had come to a primary visit in scientific department of the investigation center  at time between  1 January 2014 to 31 August 2015, were asked to complete an original compliance to clinician prescriptions (CP) questionnaire with integrated  Morisky-Green test (MG). It was filled by 479 patients  (70,1%).  In 250 of answerers there  was CCHD: 65 women (26%) and 175 men (74%). Mean age of CCHD patients was 63,6±12,5 y.o. 72,1% of them in the PROFILE registry, had higher education, 16 (6,4%) — scientific degree. Diagnosis of CHD was verified as anamnesis of myocardial infarction (MI), coronary arteriography (CAG) or exercise test in 231 (92,4%) participants.

Results. As the patients charts show, 12 patients with CCHD from 250 participants did not receive  any  medication  treatment, 15  took  medications  irregularly, and  other  223 regularly, by CP. This data  is confirmed by the results  of original questionnaires: 193 patients responded that do strictly adhere all CP on medications, and 49 (among 238) — had misused some prescriptions. By the results of 4-unit MG test, only 47 from 230 of responders were completely adherent to the treatment, and other 71 made at least one positive response, being relatively adherent. In multifactorial logistic regression, it was found that stable angina and scientific degree do increase adherence 3 times (р=0,006; OR 2,9; CI 95% [1,4;6,0]) and more than 6 times, respectively (р=0,003; OR=6,3; CI 95% [1,9;21,0]).  Also, it was shown that treatment adherence (by our original questionnaire) depends on the regularity of clinician follow-up, and office visits once per year and more do increase it more than 5 times (р=0,019, OR=5,1 CI 95% [1,3;19,9]).

Conclusion. Clinical symptoms of CHD (stable angina), scientific degree, as well as regular clinician follow-up at least once per year, are the factors increasing  overall patients adherence to CP and medication treatment compliance.

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