Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Study of the Quality of Medical Therapy and Adherence in Patients with Chronic Heart Failure (According to the COMPLIANCE Study)

https://doi.org/10.20996/1819-6446-2021-10-10

Full Text:

Abstract

Aim. Assess the medical therapy quality in patients with chronic heart failure (CHF) and patients' adherence to the treatment depending on the previous observation in a specialized medical center as part of an of an outpatient registry.

Materials and methods. An analysis of the medical therapy quality in patients with CHF was carried out as part of the COMPLIANCE prospective observational study (NCT04262583). 72 patients with CHF verified according to the protocol were included in the study. The average age of the patients was 69.1±9.5 years (31% of women and 69% of men). Patients were divided into groups: those who first applied to a specialized department during the period of the study inclusion, or those who were previously observed in a specialized department. The general adherence assessment to medical therapy was carried out using the original questionnaire «The adherence scale of the National Society for Evidence-Based Pharmacotherapy» which was supplemented with questions to assess the actual adherence to specific medical drugs recommended for patients with CHF.

Results. According to the results of the study, beta-blockers were prescribed to 70 (97.2%) patients. Angiotensin converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARBs) were recommended in 68 (94%) patients. Mineralocorticoid receptor antagonists were included in therapy in 6 out of 9 patients who were shown to be prescribed (66.6%). The choice of medical drugs within the group was not always adequate. For example, ACEi/ARBs with proven efficacy in patients with CHF were prescribed only in 72% of patients. Comparative analysis of adherence to medical therapy between patients of the selected groups demonstrated a higher adherence to the recommended therapy in patients who were previously observed in a specialized center.

Conclusion. The medical therapy quality for patients with CHF doesn't always comply with current clinical guidelines. The choice of a medical drug within a group is not always adequate. Regular observation in a specialized center contributes to a higher adherence to the recommended therapy.

About the Authors

E. T. Guseynova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Elmira T. Guseynova

Moscow, eLibrary SPIN 9267-0234



N. P. Kutishenko
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Natalia P. Kutishenko

Moscow, eLibrary SPIN 7893-9865



Yu. V. Lukina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Yulia V. Lukina

Moscow, eLibrary SPIN 8949-4964



S. N. Tolpygina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Svetlana N. Tolpygina

Moscow, eLibrary SPIN 6870-4735



V. P. Voronina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Victoria P. Voronina

Moscow, eLibrary SPIN 4456-1297



S. V. Blagodatskih
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Svetlana V. Blagodatskikh

Moscow, eLibrary SPIN 1628-3443



O. M. Drapkina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Oxana M. Drapkina

Moscow, eLibrary SPIN 4456-1297



S. Yu. Martsevich
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Sergey Yu. Martsevich

Moscow, eLibrary SPIN 7908-9554



References

1. Greene SJ, Fonarow GC, DeVore AD, et al. Titration of Medical Therapy for Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2019;73(19):2365-83. DOI:10.1016/j.jacc.2019.02.015.

2. Hernandez AF, Hammill BG, Peterson ED, et al. Relationships between emerging measures of heart failure processes of care and clinical outcomes. Am Heart J. 2010;159(3):406-13. DOI:10.1016/j.ahj.2009.12.024.

3. 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 PROFILE register). Rational Pharmacotherapy in Cardiology. 2013;9(2):133-7 (In Russ.). DOI:10.20996/1819-6446-2013-9-2-133-137.

4. Martsevich SYu, Guseynova ET, Kutishenko NP, et al. Evaluating Adherence to Medical Therapy in Patients with Chronic Heart Failure: Design and First Results of the COMPLIANCE Study. Rational Pharmacotherapy in Cardiology 2020;16(4):571-8. DOI:10.20996/1819-6446-2020-08-11.

5. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail. 2016;18(8):891-975. DOI:10.1002/ejhf.592.

6. Lukina YuV, Kutishenko NP, Martsevich SYu, Drapkina OM. The Questionnaire Survey Method in Medicine on the Example of Treatment Adherence Scales. Rational Pharmacotherapy in Cardiology. 2021;17(4):576-83. (In Russ.) DOI:10.20996/1819-6446-2021-08-02.

7. Komajda M, Schöpe J, Wagenpfeil S, et al.; QUALIFY Investigators. Physicians' guideline adherence is associated with long-term heart failure mortality in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Fail. 2019;21(7):921-9. DOI:10.1002/ejhf.1459.

8. Düngen HD, Apostolovic S, Inkrot S, et al. CIBIS-ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure. Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS-ELD trial. Eur J Heart Fail. 2011;13(6):670-80. DOI:10.1093/eurjhf/hfr020.

9. Ouwerkerk W, Voors AA, Anker SD, et al. Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study. Eur Heart J. 2017;38(24):1883-90. DOI:10.1093/eurheartj/ehx026.


For citation:


Guseynova E.T., Kutishenko N.P., Lukina Yu.V., Tolpygina S.N., Voronina V.P., Blagodatskih S.V., Drapkina O.M., Martsevich S.Yu. Study of the Quality of Medical Therapy and Adherence in Patients with Chronic Heart Failure (According to the COMPLIANCE Study). Rational Pharmacotherapy in Cardiology. 2021;17(5):738-742. https://doi.org/10.20996/1819-6446-2021-10-10

Views: 79


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


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