心血管疾病患者对最佳药物治疗的依从性

Q4 Medicine
R. Goloshchapov-Aksenov, Raphik I. Shaburov, O. Rukodaynyy, Vyacheslav O. Starikov
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引用次数: 0

摘要

介绍。改善心血管护理的一个重要原则是提高患者对最佳药物治疗的依从性。目的。确定心血管疾病患者对最佳药物治疗的依从性。材料和方法。采用改良的Morisky D.问卷(1986)对1018例心血管疾病患者进行直接连续问询。该调查由“俄罗斯铁路医学”中心临床医院的心血管外科医生(n = 3)进行。比较初诊阶段、6个月、24个月患者对医生建议执行情况的依从程度(p < 0.05)。结果。首次就诊时患者降压治疗依从性低(23.8%);血管内动脉支架植入术患者(99%)、房颤患者抗凝治疗(86%)和糖尿病患者降糖治疗(98%)对双重抗血小板治疗的依从性较高。随访6个月后,包括提供血管内及手术护理,两组患者对最佳药物治疗的依从性均提高至99.9% (p < 0.05)。随访24个月后,降压和抗凝治疗依从度分别为93.8%和97.5%,略有下降(p < 0.05)。的局限性。为了评估对医生建议的依从性,我们对18000例心血管疾病患者门诊随访2年的结果进行了分析,这是一个足够的参考样本。结论。随访12个月后,患者对最佳药物治疗的依从性较初诊时有所提高。治疗预防过程中的临床管理优化了对药物处方执行效果的控制,包括患者对血流动力学和其他指标的自我控制。“医患”体系中信任关系的形成是公共卫生改善过程中临床管理持续合规的最重要原则。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Compliance of patients with cardiovascular diseases to optimal drug therapy
Introduction. An important principle of improving cardiovascular care is to increase the compliance of patients to optimal drug therapy. Purpose. To identify compliance in patients with cardiovascular diseases to optimal drug therapy. Materials and methods. Direct continuous questioning of patients with cardiovascular diseases (n = 1,018) was carried out using a modified Morisky D. questionnaire (1986). The survey was carried out by cardiovascular surgeons (n = 3) of the Central Clinical Hospital "Russian Railways Medicine". The degree of adherence of patients to the implementation of the recommendations of doctors at the stage of the initial interview and in 6 and 24 months was compared (p < 0.05). Results. At the stage of the first consultation low compliance of patients to antihypertensive therapy (23.8%); high compliance to dual antiplatelet therapy was established in patients after endovascular arterials stenting (99%), anticoagulant therapy in patients with atrial fibrillation (86%) and hypoglycemic therapy in patients with diabetes (98%). After follow-up for six months, including the provision of endovascular and surgical care, compliance to optimal drug therapy in patients of all groups increased up to 99.9% (p < 0.05). After follow-up for 24 months, the compliance degree to antihypertensive and anticoagulant therapy slightly decreased to 93.8 and 97.5%, respectively (p > 0.05). Limitations. To assess compliance to the recommendations of doctors, the results of outpatient follow-up of one thousand eighteen patients with cardiovascular diseases over two years were analyzed, which is a sufficient reference sample. Conclusion. Compared with the initial consultation of patients, their compliance to optimal drug therapy increased during the 12 months of follow-up. Clinical management in the treatment-and-prophylactic process optimizes control over the effectiveness of the implementation of medical prescriptions, including self-control by patients of hemodynamic and other indicators. The formation of trusting relationships in the “doctor-patient” system is the most important principle of the continuity compliance of clinical management of the process of improving public health.
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