THERAPY COMPLIANCE IN AMBULATORY PATIENTS: PROFILE REGISTRY DATA

Aim. Using the data from the PROFILE Registry and the patients’ questionnaire survey, to analyse the patients’ compliance with medical recommendations on lipid-lowering therapy (LLT).

Material and methods. Over the period from May 1st 2011 to December 31st 2011, 274 patients were included in the PROFILE Registry: 82 were referred to a specialised medical centre for the first time (control group, CG); 167 were regularly attending the medical centre (main group A, MGA); and 25 last visited the centre >2 years ago (main group B, MGB). 262 patients completed a questionnaire on the therapy compliance, while 12 refused to participate in the questionnaire survey.

Results. According to the results of the questionnaire survey, MGA patients were better informed about the LLT goals (65%) than their CG and MGB peers (35% and 48%, respectively; p<0,0001). The percentage of patients who took statins every day was 87% in MGA vs. 41,5% in CG and 64% in MGB (p=0,002). Statin therapy effectiveness was controlled regularly in MGA: cholesterol (CH) levels were measured every 6 months in 37,5% and every 12 months in 28%. For CG, these figures were 17% and 16%, while for MGB, they were 15% and 40%, respectively (p<0,0001). One-third of CG patients, every fourth MGB patient, and only 13% of MGA patients did not control their CH levels (p<0,0001).

Conclusion. The MGA patients who were regularly attending the State Research Centre for Preventive Medicine were the most LLT-compliant: they were well-informed about their disease and therapy goals, were regularly taking prescribed medications (statins), and had better treatment control and the highest LLT effectiveness.

1. Osterberg L, Blaschke Т. Adherence to Medication. New Engl J Med 2005; 353:487–97.

2. Gliklich RE. Registries for Evaluating Patient Outcomes. A User’s Guide 2010; 5:19–29.

3. Kennedy L, Craig AM. Global registries for measuring pharmacoeconomic and quality-life outcomes: focus on design and data collection, analysis and interpretation. Pharmacoeconomics 2004; 22 (9):551–68.

4. Helija TG, Marcevich SYu, Selivanova GB, et al. The study of knowledge of modern principles of rational pharmacotherapy of cardiovascular disease according to a survey of physicians. CardiovascularTherapy and Prevention 2012;5:61–6. Russian (Хелия Т. Г., Марцевич С.Ю., Селиванова Г.Б. и др. Изучение знания современных принципов рациональной фармакотерапии сердечно-сосудистых заболеваний по данным опроса врачей. Кардиоваскулярная терапия и профилактика 2012; 5:61–6).

5. Martsevich SYu, Gaysenok OV, Tripkosh SG, et al. Medical supervision in specialized center and the quality of lipid-lowering therapy in patients with cardiovascular diseases (according to the PROFIL register). Rational Pharmacotherapy in Cardiology 2013;9 (2):133–8. Russian (Марцевич С.Ю., Гайсенок О.В., Трипкош С. Г. и др. Наблюдение в специализированном медицинском центре и качество гиполипидемической терапии у пациентов с сердечно-сосудистыми заболеваниями (по данным регистра “ПРОФИЛЬ”). Рациональная фармакотерапия в кардиологии 2013; 9 (2):133–8).

6. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of self-reported measure of medical adherence. Med Care 1986; 24:67–73.

7. Lukina YuV, Ginzburg ML, Smirnov VP, et al. Treatment adherence in patients with acute coronary syndrome before hospitalization. Klinicist 2012; 2:45–53. Russian (Лукина Ю.В., Гинзбург М.Л., Смирнов В.П. и др. Приверженность лечению, предшествующему госпитализации, у пациентов с острым коронарным синдромом. Клиницист 2012; 2:45–53).

8. Fürthauer J, Flamm M, Sönnichsen A. Patient and physician related factors of adherence to evidence based guidelines in diabetes mellitus type 2, cardiovascular disease and prevention: a cross sectional study. BMC Fam Pract. 20134; 14:47. doi: 10.1186/1471–2296–14–47.

9. Rübenacker S, Kaiser J, Guschmann M. Compliance of patients undergoing thromboprophylaxis with enoxaparin: the COMFORT study. Abstract in English Chirurg 2013; 84 (3):235–42. doi: 10.1007/s00104– 012–2443–2.

10. Hohlov AL, Lisenkova LA, Rakov AA. Analysis of the factors that determine adherence to antihypertensive therapy. Good clinical practice 2003;4:59– 66. Russian (Хохлов А.Л., Лисенкова Л.А., Раков А.А. Анализ факторов, определяющих приверженность к антигипертензивной терапии. Качественная клиническая практика 2003; 4:59–66).

11. Hill M, Houston N. Adherence to antihypertensive therapy. Chapter 131: 390–2.

12. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of self–reported measure of medical adherence. Med Care 1986; 24:67–73.

13. Jin J, Sklar GE, Oh MNS, Li SC. Factors affecting therapeutic compliance: A review from the patient’s perspective. Ther Clin Risk Manag 2008; 4 (1):269–86.

14. Waeber B, Burnier M, Brunner HR. How to improve adherence with prescribed treatment in hypertensive patients? J Cardiovasc Pharmacol 2000; 36 (suppl. 3): S23–6.