DIFFERENCES IN ADHERENCE BEHAVIOUR PATTERNS IN PATIENTS WITH PRIMARY AND RECURRENT MYOCARDIAL INFARCTION

Aim. To compare adherence behavior patterns in patients with primary and recurrent myocardial infarction before hospital discharge.

Methods. 145 patients with myocardial infarction admitted to the Kemerovo Regional Clinical in the period from November to December 2016 were included in a single-centre, nonrandomized, prospective study. All the patients were interviewed using the original adherence questionnaire. All the patients were divided into 2 groups: patients with primary myocardial infarction (n = 74) and recurrent (n = 71) myocardial infarction.

Results. Both, patients with primary and recurrent myocardial infarction, had low adherence to treatment and healthy lifestyle, poor disease awareness which appeared to be a signifcant factor worsening their long-term prognosis. Recurrent myocardial infarction was associated with increased readiness to adhere the treatment regimen more strictly (62%), but it was not accompanied by any improvements in patients’ awareness on the causes of the disease (36.6%), their health status (30.9%) and secondary prevention (63.3%). The great number of subjective factors affecting patients’ adherence to the long-term therapy prescribed by a healthcare professional requires the implementation of additional information management for patients with any type of myocardial infarction about the importance of subsequent therapy, special education programs, and group psychotherapy.

Conclusion. Poor adherence in patients with any myocardial infarction to the prescribed therapy after discharge (less than 80%) requires a preventive use of educational and psychological programs improving medical and social awareness and readiness to adhere to treatment prescribed by the healthcare professional.

1. Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization; 2003.

2. Danilov D.S. Terapevticheskoe sotrudnichestvo (komplaens): soderzhanie ponyatiya, mekhanizmy formirovaniya i metody optimizacii. Nevrologiya, nejropsihiatriya, psihosomatika. 2014;(2):4–12 (In Russian).

3. Baglikov A.N., Rafalsky V.V. The Value of Compliance During Chronic Administration of Acetylsalicylic Acid in Patients With Acute Coronary Syndrome: Results of The Study "FORPOST". Kardiologiya, 2012; 52(9):22-28 (In Russian).

4. Dzhakubekova A.U., Kazymbekov K.R. Sovremennoe sostoyanie problemy priverzhennosti pacienta k lecheniyu (obzor). Vestnik KGMA im. I.K. Ahunbaeva, 2012; 4: 42-47 (In Russian).

5. Semenova O.N., Naumova E.A., Mihnevich N.M. Fokusirovannoe interv'yu pacientov s zabolevaniyami serdechno-sosudistoj sistemy i ih vrachej dlya ocenki priverzhennosti k dlitel'noj terapii. Byulleten' medicinskih internet-konferencij, 2013;3(6):940 (In Russian).

6. Ruda M.YA., Golicyn S.P., Gracianskij N.A., Komarov A.L., Panchenko E.P., Staroverov I.I., Tereshchenko S.N., YAvelov I.S. Nacional'nye rekomendacii po diagnostike i lecheniyu bol'nyh ostrym infarktom miokarda s pod"emom segmenta ST. Kardiovaskulyarnaya terapiya i proflaktika. 2007; 6 (8) S1: 415-500 (In Russian).

7. Petrov G.P., Petrov A.G., Semenikhin V.A. Methodic approaches to evaluation of individual life quality of coal industry workers. Occupational Health and Industrial Ecology. 2015; 5:22-25 (In Russian).

8. Semenikhin V.A., Petrov A.G., Petrov G.P. Methodic approaches to pharmaco-economic evaluation of vibration disease inpatient treatment in miners. Occupational Health and Industrial Ecology. 2015; 5:29-34 (In Russian).

9. YAstrebov V.S. Problemy paternalizma i partnerstva v psihiatrii. Psihiatriya. 2012:4(56);7–13 (In Russian).

10. Claxton A.J., Cramer J., Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2012; 23:1296-1310.

11. Fofanova T.V. Priverzhennost' k lecheniyu v medicinskoj praktike i vozmozhnye metody ee povysheniya. Kardiologicheskij vestnik. 2011; VI(XVIII), 2:46-53 (In Russian).

12. Bosworth H.B., Granger B.B., Mendys P., Brindis R., Burkholder R., Czajkowski S.M. et al. Medication Adherence: A Call for Action. Am Heart J. 2011; 162 (3):412–424. DOI: 10.1016/j.ahj.2011.06.007.

13. Erlih A.D., Barbarash O.L., Kashtalap V.V., Gratsiansky N.A. Ompliance with clinical practice guidelines for non ST-segment elevation acute coronary syndrome: association between outcomes and predictors of poor management (RECORD-3 registry data). Complex Issues of Cardiovascular Diseases. 2016, 2: 75-82 (In Russian).

14. Martynov A.A., Spiridonova E.V., Butareva M.M. Increasing compliance to treatment and rehabilitation programs in patients in hospitals, outpatient and policlinic departments, and factors having an effect on compliance '. Vestnik dermatologii i venerologii, 2012;1:21-27 (In Russian).

15. Mann D.M., Allegrante J.P., Natarajan S., Halm EA, Charlson M. Predictors of Adherence to Statins for Primary Prevention. Cardiovasc Drugs Ther 2007; 21: 311–6.

16. Checchi K.D., Huybrechts K.F., Avorn J. Kesselheim ASElectronic medication packaging devices and medication adherence: a systematic review. JAMA. 2014; 312 (12): 12371247. DOI: 10.1001/jama.2014.10059.

17. Fofanova T.V. Ageev F.T., Smirnova M.D., Svirida O.N., Kuzmina A.E., Thostov A.Sh., Nelyubina A.S. National questionnaire of treatment compliance:testing and application in outpatient practice. Sistemnye gipertenzii. 2014; 2:13-16 (In Russian).

18. Pandey A., Raza F., Velasco A., Brinker S., Ayers C., Das S.R. et al. Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoring in apparent treatmentresistant hypertension.J Am Soc Hypertens. 2015; 9 (6):420-426. e2. DOI: 10.1016/j.jash.2015.04.004.

19. Patel A., Cass A., Peiris D., Usherwood T., Brown A., Jan S. et al. A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk. Eur J Prev Cardiol 2015; 22(7):920-30. DOI: 10.1177/2047487314530382.

20. Pérez-Escamilla B., Franco-Trigo L., Moullin J.C., Martínez-Martínez F., García-Corpas J.P. Identifcation of validated questionnaires to measure adherence to pharmacological antihypertensive treatments. Patient Prefer Adherence. 2015; 9:569578. DOI: 10.2147/PPA.S76139.