ASSESSMENT OF PATIENTS COMPLIANCE FOR AMBULATORY INSTITUTIONS VISITS AND ITS INFLUENCE ON THE QUALITY OF TREATMENT BEFORE DEVELOPMENT OF ACUTE CORONARY SYNDROME, BY THE LIS-3 REGISTRY

Aim. To study the compliance of patients to visits in outpatient institutions (OI) with the data from acute coronary syndrome registry (ACS) LIS-3, prior to ACS development, and evaluate the quality of pre-hospital therapy among patients with different compliance.

Material and methods. Patients (n=320), hospitalized toLubertsyDistrictHospital№2 with ACS, were selected to 3 groups depending on OI visiting before ACS: group A — compliant (n=139); group B — partially compliant; group C — non-compliant to OI (n=78). A score invented for the assessment of pre-hospital quality of management, made up via comparison of real life therapy with the recommended in Clinical Guidelines (CG) taken anamnesis of cardiovascular pathology. Results. Compliance for OI visiting was associated with female gender, older age, CVD anamnesis (especially 2 and more CVD comorbidity) (p<0,0001), acute brain circulation disorder (ABCD), diabetes (DM). Compliance is lower in working patients and in smokers. Educational level, as marital status and obesity did not influence OI visiting compliance.

There was low prescription rate for any medication, even among those with CVD in anamnesis. There is a decrease traced of prescription deficit for some drug groups for primary and secondary prevention of ACS together with the patients compliance decrease. Better compliance is associated with better quality of pre-hospital therapy (p<0,0001).

Conclusion. Compliance for OI visiting before ACS onset is higher among women, older and sedentary people, CVD patients, after ABCD and having DM. Management quality before ACS onset is generally poor, even in presence of CVD diagnosed during pre-hospital stages. Patients compliance for OI visiting generally improves quality of therapy, but not completely matches with the guidelines.

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