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LOW ADHERENCE TO TREATMENT AFTER MYOCARDIAL INFARCTION: CAUSES AND WAYS OF ADJUSTMENT CONSIDERING PSYCHO-EMOTIONAL STATE OF PATIENTS

https://doi.org/10.20996/1819-6446-2016-12-3-291-295

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Abstract

Aim. To study the reasons of low adherence to treatment in patients after myocardial infarction as well as methods of its correction considering the mental and emotional state of patients. Material and methods. Patients (n=115) after myocardial infarction registered in "Acute Myocardial Infarction Register» were enrolled into the study. The Moriscos-Green scale was used to determine the degree of adherence to treatment, and psycho-emotional state of patients was assessed by the Hospital Anxiety and Depression Scale (HADS). The special questionnaire was used to study the causes of poor adherence. Results. Only 45% of patients after myocardial infarction have a high commitment to the doctor's recommendations. The main reason for low adherence was forgetfulness (42%). Among other reasons were: fear of side effects (16%); lack of therapeutic effect according to patients' opinion (12%); doubts about the doctor's prescriptions (14%); a large number of prescribed drugs (12%); high cost of drugs (4%). The structure of the causes of poor adherence to treatment varied greatly depending on the psycho-emotional status. Adherence to treatment can be improved by specific physician’s actions (48.5% of patients). At the same time 14% of patients did not want to take drugs for a long time under any circumstances. Conclusion. Adherence to treatment of patients after myocardial infarction deserves attention from doctors. The personalized approach considering patient’s opinion, as well as their specific features, is essential for the development of ways to improve adherence.

About the Authors

E. A. Kuzheleva
Research Institute of Cardiology. Kievskaya ul. 111-A, Tomsk, 634012 Russia
Russian Federation


K. N. Borel'
Research Institute of Cardiology. Kievskaya ul. 111-A, Tomsk, 634012 Russia
Russian Federation


A. A. Garganeeva
Research Institute of Cardiology. Kievskaya ul. 111-A, Tomsk, 634012 Russia
Russian Federation


References

1. Treatment of acute coronary syndrome without persistent ST-segment elevation on the electrocardiogram: Russian recommendations. Kardiovaskulyarnaya Terapiia I Profilaktika 2006; 5(8): suppl 1: 1-35. In Russian (Национальные рекомендации по лечению острого коронарного синдрома без стойкого подъема ST на ЭКГ. Кардиоваскулярная терапия и профилактика 2006; 5 (8) приложение 1: 1-35.

2. Aronov D.M., Bubnova M.G., Barbarash O.L. et al. Acute myocardial infarction with ST-elevation of the electrocardiogram: rehabilitation and secondary prevention: Russian clinical guidelines. Kardiosomatika 2014: suppl 1: 24-7. In Russian (Аронов Д.М., Бубнова М.Г., Барбараш О.Л. и др. Острый инфаркт миокарда с подъемом сегмента ST электрокардиограммы: реабилитация и вторичная профилактика. Российские клинические рекомендации. КардиоСоматика 2014: приложение 1: 24-7).

3. Smith Jr S.C., Benjamin E.J., Bonow R.O. et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update. Circulation 2011; 124: 2458-73.

4. Garganeeva A.A, Kuzheleva E.A, Efimova E.V., Tukish O.V. Drug therapy of patients with myocardial infarction as the most important component of a polyclinic stage of cardiorehabilitation. Kardiosomatika 2015; 3: 22-6. In Russian (Гарганеева А.А., Кужелева Е.А., Ефимова Е.В., Тукиш О.В. Медикаментозная терапия пациентов, перенесших инфаркт миокарда, как важнейшая составляющая поликлинического этапа кардиореабилитации. Кардиосоматика 2015; 3: 22-6).

5. Muromtseva G.A., Kontsevaya A.V., Konstantinov V.V., et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Kardiovaskulyarnaya Terapiia I Profilaktika 2014; 13 (6): 4-11. In Russian (Муромцева Г.А., Концевая А.В., Константинов В.В., Артамонова Г.В. и др. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012-2013гг. Результаты исследования ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика 2014; 13(6): 4-11).

6. Haynes R.B., Taylor D.W., Sackett D.L., et al. Determinants of compliance: The disease and the mechanics of treatment. Compliance in health care. Johns Hopkins University Press 1979: 49-62.

7. Safronenko V.A, Chesnikova A.I., Khripun A.V. Features of coronary heart disease in patients with 5-year history of myocardial infarction depending of adherence. Meditsinskii Vestnk Yuga Rossii 2013; 1: 60-3. In Russian (Сафроненко В.А., Чесникова А.И., Хрипун А.В. Особенности течения ишемической болезни сердца у пациентов с 5-летним анамнезом инфаркта миокарда в зависимости от приверженности к терапии. Медицинский вестник Юга России 2013; 1: 60-3).

8. Tuppin P., Neumann A., Danchin N. et al. Evidence-based pharmacotherapy after myocardial infarction in France: Adherence-associated factors and relationship with 30-month mortality and rehospitalization. Archives of Cardiovascular Diseases 2010; 103(6): 363-75.

9. Bosworth H. Medication Adherence. In: Bosworth H., ed. Improving Patient Treatment Adherence: A Clinician's Guide. New York: Springer; 2010: 68-94

10. Garganeeva A.A., Okrugin S.A., Efimova E.V., Borel K.N. "Registry of acute myocardial infarction" as the population information system of evaluation of the epidemiological situation and medical care to patients with acute myocardial infarction. Serdce 2013; 1(12): 37-41. In Russian (Гарганеева А.А., Округин С.А., Ефимова Е.В., Борель К.Н. «Регистр острого инфаркта миокарда» как информационная популяционная система оценки эпидемиологической ситуации и медицинской помощи больным острым инфарктом миокарда. Сердце 2013; 1(12): 37-41).

11. Morisky D.E., Green L.W., Levine D.M. Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care 1986; 24(1): 67-74.

12. Lukina Yu.V., Ginzburg M.L., Smirnov V.P. et al. Treatment compliance, in patiens with acute coronary syndrom before hospitalization. Klinitsist 2012; 2: 41-9. In 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: 41-9).

13. Konradi A.O. Increased compliance - a way to success in the treatment of cardiac patients. Spravochnik poliklinicheskogo vracha 2010; 7: 20-4. In Russian (Конради А.О. Повышение приверженности терапии - путь к успеху в лечении кардиологических больных. Справочник поликлинического врача 2010; 7: 20-4).


For citation:


Kuzheleva E.A., Borel' K.N., Garganeeva A.A. LOW ADHERENCE TO TREATMENT AFTER MYOCARDIAL INFARCTION: CAUSES AND WAYS OF ADJUSTMENT CONSIDERING PSYCHO-EMOTIONAL STATE OF PATIENTS. Rational Pharmacotherapy in Cardiology. 2016;12(3):291-295. https://doi.org/10.20996/1819-6446-2016-12-3-291-295

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)