STUDY OF PATIENT AWARENESS AND AUTONOMY FOR PUBLIC HEALTH NEEDS (ON THE EXAMPLE OF A CROSS-SECTIONAL STUDY OF PEOPLE WITH HYPERTENSION IN DNIPRO)

Abstract

The aim of the study is to find out awareness about the presence of high blood pressure (BP), to investigate the autonomy in medical decision-making and to determine the factors influencing the situation on the example of people with hypertension. Material and methods. The study was made on the basis of data obtained during the project "May measurement month" of the International Society of Hypertension (2017-2019), which involved employees and students of the Dnipro State Medical University. A cross-sectional study of blood pressure was made among 757 adult residents of Dnipro. The presence of hypertension was determined according to the approaches of this project. General information, data on risk factors and health behaviors were determined based on the results of the survey. Data processing was performed using standard statistical tools. Results. The study involved 476 (62.9%) women and 281 (37.1%) men aged 18 to 90 years. Hypertension was detected in 31.8% (95% CI 28.5 % - 35.3%). Hypertension was more common in the elderly. Among the controlled risk factors in the respondents were the most common – high BMI, smoking, alcohol consumption. More than two-thirds of people with high blood pressure were unaware of their condition and did not receive appropriate treatment, while almost half of patients did not achieve blood pressure control even while taking medication. Only 17.4% (95% CI 14.8% - 20.3%) of persons received appropriate antihypertensive treatment, which corresponds to 54.8% of detected cases of hypertension. The use of these antihypertensive drugs, which is a manifestation of patients' autonomy, their conscious decision to adhere to the prescribed treatment, according to the study depends on the age of patients and the presence of aggravating factors: increased BMI, myocardial infarction and/or stroke. Conclusions. According to the study, the facts were revealed that people with hypertension are poorly informed about their own health and low propensity to make decisions about its support. This justifies the need for more thorough involvement of the population in the process of health care with increasing their awareness and autonomy, including awareness of opportunities in making medical decisions about their own health.