The Efficacy of Antihypertensive Therapy in Elderly Patients and Treatment Compliance Analysis

Olejnikov, V. E.; Eliseeva, I.; Tomashevskaya, Y.; Борисова, Н. А.; Fadeeva, S. S.

doi:10.20996/1819-6446-2014-10-4-391-396

Cited by 4 publications

(7 citation statements)

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“…None of the randomized studies were blinded. In four of the prospective observational intervention studies, it was only possible to extract baseline data as follow up data were not reported [24, 28, 30, 34]. Results from these studies were transformed into cross-sectional data.…”

Section: Resultsmentioning

confidence: 99%

“…Adherence was assessed using data from cross-sectional surveys and from baseline data in prospective observational intervention studies. In studies using the MMAS-4 [11–19, 21, 23–27, 30, 33] adherence to AHT varied from 1.62 ± 0.27 [11] to 3.12 ± 0.86 points [35] out of a maximum of four (Additional file 3). Among these studies, the highest rates of adherence were found in post-marketing studies, all with large sample sizes.…”

Section: Resultsmentioning

confidence: 99%

“…Many studies included quite large samples, from several hundred to several thousand people [12, 13, 16–19, 24, 26, 29, 35, 38, 39], but some were much smaller, from 30 to 75 people [11, 15, 20, 22, 25, 30–32, 36, 37, 40]. The follow up period varied from 6 weeks [23] to 12 months [12, 13, 36, 37].…”

Section: Discussionmentioning

confidence: 99%

“…In the vast majority of studies, the antihypertensive effect of adherence was measured as mean BP or probability of achieving target BP levels. Only one study measured 24-h BP [30] or used home BP monitoring [37].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore it is impossible to estimate independent association between HT and adherence.Fofanova et al [27]2014Patients who visited outpatient department of the Russian Cardiology Scientific and Production CenterMen and women with HT and examined by psychiatristsCross-sectional16119–75 (female)/53.4 ± 11.4 (male)1(a) assessment of adherence and psychosomatic aspects;(b) groups selected on basis of adherence to treatment: low adh – 131 ppl, high adh – 30 pplSoboleva et al [28]2012Regional clinical hospital and ambulatory care facilityPatients with grades 1–3 of HT and cardiovascular disease. Recruitment process not described.Cross-sectional24218 y and older1–3(b) only possible to extract baseline dataOganov et al [29]2007Patients attending 512 physicians in 20 citiesMen or women with HT and/or IHDCross-sectional249618 y and older1–3(a) big sample size;(b) no prospective stageOlejnikov et al [30]2014Not statedThe authors are affiliation at Penza State Medical UniversityMen or women older than 60, with grades 1–2 of HT.Recruitment process not describedCross-sectional7566.6 ± 4.71–2(a) studying adherence in the elderly;(b) non-standard way of MMAS-4 analyze, small sample size, only possible to extract baseline dataSmirnova et al [31]2012Ambulatory care facilityPatients aged 45–75, with grades 1–2 of HT. Recruitment process not describedRandomized non-blinded controlled intervention study60Intervention group: 62 ± 9.4, control group: 63 ± 8.91–2(a) complex intervention on adherence;(b) small sample size, relatively short follow up period – 3 mthVologdina et al [32]2009Not statedMen and women with IHD and grades 1–2 of HT.…”

Section: Methodsmentioning

confidence: 99%

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Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017

et al. 2019

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Background Arterial hypertension (HT) is common in the Russian adult population, with half of affected individuals inadequately controlled. Low adherence to medication seems likely to be a factor. We report a scoping review of studies on adherence to antihypertensive therapy (AHT) in Russia to determine the extent of research undertaken, the frequency of adherence among adults diagnosed with HT, methodologies used in the studies, and their ability to describe determinants of adherence. Methods A scoping review of published studies that have assessed adherence to AHT in Russian HT patients searched the main Russian and international electronic databases eLIBRARY.ru, Russian Medicine, Embase, MEDLINE for full-text reports published in the Russian language between 2000 and 2017. The last search was on November 28, 2017. Among 520 reports identified, 31 were included in the review. Results Eighteen studies assessed adherence using the 4-item Morisky Medication Adherence Scale (MMAS-4); others used bespoke questionnaires or pill counts. 25 studies assessed levels of adherence, 11 examined its determinants, and 18 examined intervention strategies. The proportion of “adherent” patients varied from 11 to 44% using the MMAS-4, from 23 to 74% when using bespoke questionnaires, and from 5 to 43% when using pill counts. Adherence was associated with sociodemographic factors, access to free drugs provided through the Medicine Assistance Scheme (MAS), use of home blood pressure (BP) monitoring, anxiety, and comorbidity. There was no evidence that adherence was associated with income or physical activity. Evidence of an association between MAS, grade of HT, or experience of hypertensive crisis was inconclusive. Various methods to improve adherence were studied including patient education (improved from 1.8 to 3.9 points, p = 0.0002 or 2.80 to 3.79 points, p < 0.0001 measured by the MMAS-4), telephone reminders (p < 0.0001), training in home BP monitoring (p < 0.05), and use of fixed-dose combinations (p < 0.05). Conclusions The main determinants of adherence to AHT are sociodemographic characteristics, the severity of HT, and presence of comorbidity. Patient education and use of fixed-dose combinations of drugs were identified as most important for improving adherence. Most studies assessing adherence use self-reported methods so there is a need for greater use of objective methods. Trial registration This scoping review has not been registered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017

et al. 2019

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Impact of remote follow-up on the course of hypertension

Bubnova¹,

Трибунцева²,

Ostroushko³

et al. 2018

Profil. med.

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Pharmacological drug interactions in the treatment of community-acquired pneumonia in hospital settings (based on electronic databases of reported drug interactions)

Жукова

Khoroshavina

Руина

et al. 2021

Pulʹmonologiâ (Mosk.)

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The article presents the results of a study of potential drug interactions in the treatment of moderate and severe community-acquired pneumonia (CAP) in hospital settings. The study was conducted by analysis of treatment standards and data from real clinical practice regarding antimicrobial therapy. Methods. The study used the lists of drug products for medical use for the treatment of CAP (according to the standards of specialized medical care for moderate and severe CAP with complications). Also, the medical records of patients (n = 165) with CAP, hospitalized in hospitals of medical organizations (Nizhny Novgorod) were used. The study period was 2 years (2015 - 2016). The study included all patients admitted to the hospital during the analyzed period. CAP was treated in accordance with treatment standards. Results. The analysis of potential interactions of drugs used for moderate and severe CAP according to the treatment standards, showed that 27 and 72 drugs can be used, respectively. 325 potential interactions are possible in hospital settings for moderate CAP and 2,485 for severe CAP. According to the treatment standard, the number of minimally clinically significant potential interactions during the pharmacotherapy of moderate CAP in hospital settings is 8, the number moderately clinically significant interactions - 19; undesirable interactions - 7. In case of severe CAP, the number of potential interactions increases and amounts to 27 minimally clinically significant, 105 moderately clinically significant, and 41 undesirable. The analysis of the results of antimicrobial therapy in real clinical practice showed 4 therapeutic duplications (prescribing 2 β-lactam antibacterial drugs simultaneously) and 2 moderately clinically significant interactions during antimicrobial therapy in hospital 1. Only 1 therapeutic duplication was noted during antimicrobial therapy in hospital 2. Therapeutic overlap has been found between β-lactam antibacterial drugs (ceftaroline fosamil and meropenem). It is advisable to prescribe no more than one в-lactam antibacterial drug and it is inappropriate to include > 3 antimicrobial drugs in an antimicrobial regimen. Conclusion. Electronic databases simplify the selection of medicines and thus ensure the safe and effective use of registered drug interactions.

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The Efficacy of Antihypertensive Therapy in Elderly Patients and Treatment Compliance Analysis

Cited by 4 publications

References 2 publications

Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017

Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017

Impact of remote follow-up on the course of hypertension

Pharmacological drug interactions in the treatment of community-acquired pneumonia in hospital settings (based on electronic databases of reported drug interactions)

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