Katerenchuk I. P., Mochnachov О. V

COMPLIANCE AS PREREQUSITE OF THERAPEUTICAL EFFECTIVNESS OF COMORBID ESSENTIAL HYPERTENSION TREATMENT


About the author:

Katerenchuk I. P., Mochnachov О. V

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scentific article

Annotation:

The treatment of patients with comorbidities has some features due to the risk of polypharmacy and occurrence of drugs side effects. Therefore, the choice of therapy for patients with comorbid pathology should be based primarily on the principles of safety and so, should be directed to the prescription of limited number of drugs, as well, as to the careful patient’s compliance to the prescribed treatment. In order to increase adherence to treatment, we examined 127 patients in the age of 54 to 78 years suffering on essential hypertension (EH) associated with coronary arteries disease (CAD) in form of unstable angina combined with disturbances of purine metabolism and obesity. Participants of the study were divided into 2 experimental groups. The first experimental group was formed by 57 patients suffering on EH, CAD and obesity, the second group was presented with 50 patients with EH, CAD, obesity and purine metabolism disturbances. Dynamic follow-up of patients was performed in 6, 12 and 18 months’ periods. By using questionnaires, we examined the working capacity of patients, the duration of therapeutic treatment, doses of drugs and patients’ adherence to provided medical prescriptions. We analyzed complaints of the patients, performed physical examinations, blood pressure measurements results, 24-hours blood pressure monitoring results, 24-hours ECG monitoring results and blood lipids metabolism abnormalities. All patients were examined on the level of social adaptation and compliance by Morrisco-Green method to clarify the necessity for careful treatment control. Results of the study. After 6 months of study, the results of the compliance level assessment have not changed significantly. There was a higher level of compliance among patients with predominant kinesthetic perception (2.4, 2.4 and 2.8, in the control, the first and the second experimental groups, respectively) and lower level of compliance among the patients with predominant visual perception (1.8, 2.0, 2.1 in the control, the first and the second experimental groups, respectively). After 18 months of treatment the compliance rate increased significantly in all groups, but especially in patients with predominant kinesthetic perception (from 2.5, 2.6 and 2.9 to 3.6, 3.7 and 3.9 in the control, in the first and in the second groups, respectively). Improvement of the compliance level among the patients with predominant visual perception was changed from 1.8, 2.0, 2.1 to 3.1, 3.1 and 3.5 in the control, in the first and in the second group, respectively. In group of patients with predominant audial perception it changed from 2.2, 2.3 and 2.6 to 3.2, 3.3, 3.6 in studied groups. Results of our study have highlighted the presence of strong dependence of compliance level with the patient’s main representative systems. Thus, the lowest level of compliance was found in patients with visual perception (2.1, 2.0, 2.1). At the same time, the level of compliance was the highest in patients with predominant kinesthetic system (2.7, 2.6, 2.7). One of the important reasons for low compliance in long-term use of antihypertensive drugs in patients with a comorbid course of arterial hypertension is the lack of information perception in communication between physician and patient, which is determined by the peculiarities of information presentation as well as by the type of predominant representative system of the patient. The lowest type of compliance is noted among patients with visual perception predominance. During the long-term treatment period the perception of information and adherence to treatment are continuously changing. So, its necessitates the importance of dynamic changes in neuro-linguistic programming, taking into account the peculiarities of language predicates and determination of the leading representative system.

Tags:

essential hypertension, coronary arteries disease, gout, obesity, compliance, treatment.

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Publication of the article:

«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 120-123 pages, index UDK 159.09:616.12-008.331.1

DOI: