Medication adherence in patients with stable coronary artery disease in primary care

Авторы

DOI:

https://doi.org/10.3897/rrpharmacology.6.54130

Аннотация

Introduction: Lack of research targeting non-adherence to cardiovascular medications in Russia prevents from devel­oping effective interventions to improve adherence. The aim was to study medication adherence in patients with stable coronary artery disease in primary care.

Material and methods: The study was conducted in a primary care setting of Moscow. Demography, medical history, pharmacotherapy data were obtained retrospectively from 386 coronary patients’ medical records. Medication adher­ence was measured by 8-item Morisky Medication Adherence Scale (MMAS-8). A statistical analysis was performed using SPSS Statistics V16.0.

Results and discussion: According to the results from MMAS-8, 188 (48.7%) coronary patients had high medication adherence, 135 (35.0%) – moderate, and 63 (16.3%) – low. By the dichotomous interpretation: 48.7% (n = 188) – were adherent, 51.3% (n = 198) – were non-adherent. These groups were similar in gender distribution, age, and medical history profile (p > 0.1 for all variables). Smokers prevailed in the non-adherent group (13.6 vs. 5.3%; p = 0.009). Both groups were equally prescribed beta-blockers, antiplatelets, and statins (p > 0.1 for all). Use of fixed dose combinations (11.7 vs. 5.6%; p = 0.048) and the number of pills taken (mean 5.64 ± 1.52 vs. 5.99 ± 1.62; p = 0.029) were associated with better adherence. Higher values of total cholesterol (mean 5.2 ± 1.4 vs. 4.7 ± 1.2 mmol/L; p < 0.001) and low-den­sity lipoprotein cholesterol (mean 2.9 ± 1.2 vs. 2.4 ± 0.9 mmol/L; p < 0.001) were revealed in non-adherents. Subjects with suboptimal adherence visited general practitioners more frequently (median 5 vs. 3 visits; p = 0,003).

Conclusion: Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patient. Smoking and poorer control of blood lipids prevailed in non-adherents, who also caused higher load on general practitioners.

Ключевые слова:

coronary artery disease, medication adherence, Morisky scale, primary care

Вклад авторов

Sergey K. Zyryanov, RUDN University

Doctor Habilitated of Medical Sciences, Professor, Head of the Department of Pharmacology and Clinical Pharmacology, Medical Institute.

Sergey B. Fitilev, RUDN University

Doctor Habilitated of Medical Sciences, Professor, Professor of the Department of Pharmacology and Clinical Pharmacology, Medical Institute.

Alexander V. Vozzhaev, RUDN University

Candidate of Biological Sciences, Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Medical Institute.

Irina I. Shkrebniova, RUDN University

Candidate of Medical Sciences, Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Medical institution.

Natalya N. Shindryaeva, City Polyclinic #2 of Moscow Healthcare Department

Doctor of Medical Sciences, Professor, Head Physician.

Dmitry A. Klyuev, RUDN University

Post-graduate student at the Department of Pharmacology and Clinical Pharmacology, Medical Institute.

Liusine N. Stepanyan, RUDN University

Post-graduate student at the Department of Pharmacology and Clinical Pharmacology, Medical Institute.

Nikolay N. Landyshev, RUDN University

Student of Medical Institute.

Yana G. Voronko, RUDN University

Student of Medical Institute.

Загрузки

Опубликован

30.06.2020

Как цитировать

Zyryanov SK, Fitilev SB, Vozzhaev AV, Shkrebniova II, Shindryaeva NN, Klyuev DA, Stepanyan LN, Landyshev NN, Voronko YG (2020) Medication adherence in patients with stable coronary artery disease in primary care. Research Results in Pharmacology 6(2): 97–103. https://doi.org/10.3897/rrpharmacology.6.54130

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Обзорная статья