The factors determining adherence to treatment in arterial hypertension patients (literature review)

Machilskaya, O. V.

doi:10.17116/kardio20169355-65

Cited by 11 publications

(3 citation statements)

References 76 publications

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“…В настоящее время общепризнанно, что эффективность лечения АГ зависит не только от правильной и своевременной постановки диагноза и выбора оптимальной стратегии и тактики лечения, но и от соблюдения пациентами предписанного режима терапии [4].…”

Section: Discussionunclassified

Efficiency of remote blood pressure monitoring in outpatients with hypertension: a pilot project in a city ambulatory care clinic

2021

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Aim. In a pilot project, to evaluate the effectiveness of remote blood pressure (BP) monitoring in outpatients followed up for hypertension (HTN).Material and methods. A total of 1,121 patients (707 women and 414 men) with hypertension were included in the pilot project (mean age, 52,0±12,0 years; BP, 151,4±9,1/96,9±10,3 mm Hg). Patients independently measured BP and entered the values into self-management paper diaries (n=886), in digital form to their personal account (n=200), or transmitted data from BP monitor using installed mobile application (n=35). Each of the three groups was assessed at baseline and after 6 months. We assessed achievement of BP targets, medication adherence using the Morisky Green scale, the prevalence of patients with fixed-dose antihypertensive therapy, and the ambulance call rate.Results. Prior to the study, 15,2% (n=171) of hypertensive patients regularly monitored their BP. After 6 months, the mean systolic BP decreased from 151,4±9,1 to 135,5±10,1 mm Hg (p<0,01), diastolic BP — from 96,9±10,3 to 85,8±6,3 mm Hg (p<0,01). The proportion of patients adhering to treatment (Morisky Green score of 4) increased from 17,9 to 55,4%, the frequency of prescribing dual antihypertensive therapy — from 25,8 to 43,3%, triple therapy — from 11,5 to 22,9%, fixed-dose combinations — from 25,4 to 51,6%. At the same time, the proportion of patients who achieved the target BP values increased from 14,5 to 43,1%, while the ambulance call rate decreased from 19,3 to 16,9%.Conclusion. The use of remote BP monitoring methods, including BP monitors with automated data transmission, increases the prescription rate of combined antihypertensive therapy and proportion of patients who achieved the target BP, as well as decreases the ambulance call rate.

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Section: Discussionunclassified

Efficiency of remote blood pressure monitoring in outpatients with hypertension: a pilot project in a city ambulatory care clinic

2021

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“…Недостаточная результативность антигипертензивной терапии (АГТ) может быть связана с неточной диагностикой, неверной стратификацией рисков [4], погрешностями измерения артериального давления (АД), резистентностью к терапии [5]. Одной из наиболее распространенных причин неэффективности лечения является несоблюдение рекомендаций по лекарственной терапии и коррекции образа жизни, что, зачастую, остается не выявленным [6,7]. В актуальных клинических рекомендациях по диагностике и лечению АГ был значительно расширен раздел, касающийся методов повышения приверженности лечению, а низкая приверженность названа одним из главных факторов неэффективности АГТ [2,8].…”

Section: Introductionunclassified

Effective antihypertensive therapy: focus on adherence management

Бунова

Жернакова

Fedorin

et al. 2020

Cardiovasc Ther Prev

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High medical adherence is a prerequisite for achieving goals in the treatment of hypertension (HTN). The majority of patients with HTN showed low adherence to treatment, which requires finding ways to solve this problem. This review describes the factors influencing adherence, ways of its assessment, and analyzes methods of increasing medical adherence in hypertensive patients. Noteworthy is the lack of publications describing the effectiveness of methods for increasing long-term (>2 years) adherence in hypertensive patients. The review also describes a not fully clear individualized approach, which consists in choosing a therapy regimen based on levels of medical adherence, medical follow-up and lifestyle modification.

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“…), а также факторами, связанными с пациентами. Прежде всего,-это низкий уровень приверженности лечению, выражающийся в несоблюдении или неполном соблюдении пациентами назначенной АГТ, на что, в свою очередь, оказывают влияние различные аспекты фармакотерапии и особенности самих пациентов [3]. Настоящее исследование было посвящено изучению и оценке этих факторов.…”

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Barriers to effective outpatient hypertension treatment: a view of physicians and patients

Недогода

Sabanov

Bychkova³

2020

Russ J Cardiol

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Aim. To study the opinion of primary care physicians and hypertensive (HTN) outpatients with different compliance rate on factors preventing effective antihypertensive therapy (AHT).Material and methods. Primary care physicians and HTN outpatients were questioned. Questionnaires for physicians and patients included informative and survey parts, with a list of possible factors aggravated adherence to treatment. The assessment was carried out using visual analogue scale. The patient questionnaire also included questions about AHT and the eight-item Morisky Medication Adherence Scale (MMAS-8). The calculation was carried out with a 95% confidence interval (CI).Results. The survey involved 298 physicians and 517 patients. Among patients, about 1% had a high compliance rate, 34% — moderate, 65% — low. In all groups, AHT did not significantly differ and was characterized by a low frequency of prescribing fixeddose combinations (27,1%). According to physicians, the most significant and equivalent are the economic aspects of treatment — 7,9±2,1 (95% CI: 7,51-8,38), the need for lifestyle change — 7,9±2,4 (95% CI: 7,37-8,38) and, to a slightly lesser extent, psychological aspects 6,8±2,2 (95% CI: 5,43-6,43). The economic aspects of treatment and need for lifestyle change were also most significant factors according to patients with high (8,8±1,8 (95% CI: 7,23-10,37) and 8,4±1,7 (95% CI: 6,93-9,87), respectively) and low (95% CI: 6,4±3,0 (5,65-7,07) and 6,2±2,8 (95% CI: 5,5-6,82) respectively) compliance rates. For patients with moderate compliance rate, the most significant and almost equivalent factors were the need for lifestyle change — 5,6±3,3 (95% CI: 4,53- 6,71), the need for regular visits — 5,6±3,1 (95% CI: 4,53-6,58) and the need for selfmanagement — 5,6±2,8 (95% CI: 4,63-6,48).Conclusion. The results obtained make it possible to forecast the compliance rate of patients with HTN, and, therefore, direct more efforts to those with a low rate, thereby increasing the effectiveness of AHT.

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The factors determining adherence to treatment in arterial hypertension patients (literature review)

Cited by 11 publications

References 76 publications

Efficiency of remote blood pressure monitoring in outpatients with hypertension: a pilot project in a city ambulatory care clinic

Efficiency of remote blood pressure monitoring in outpatients with hypertension: a pilot project in a city ambulatory care clinic

Effective antihypertensive therapy: focus on adherence management

Barriers to effective outpatient hypertension treatment: a view of physicians and patients

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