Prognosis of medical and economic efficiency of a patient-oriented program implementation aimed at formation of adherenceto drug therapy among rural population
E A Kitaeva , T A Suetina , M A Kitaev , E A Bakirova , L Ya Salyakhova , A Yu Vafin
Kazan medical journal ›› 2018, Vol. 99 ›› Issue (1) : 92 -100.
Prognosis of medical and economic efficiency of a patient-oriented program implementation aimed at formation of adherenceto drug therapy among rural population
Aim. Development and implementation of novel organizational management technologies of medical care aimed at formation of adherence to drug therapy in patients from rural areas and calculation of medical and economic efficiency of implementation of this project.
Methods. The study subject was the population of Rybnaya Sloboda district of the Republic of Tatarstan. Patient recruitment into the groups was conducted in the polyclinic of Rybnaya Sloboda central regional hospital. The duration of the study was 6 months for each of two groups with further follow-up and evaluation of adherence to therapy for 2 months.
Results. Annually stroke affects 5.6 to 6.6 million of people around the world, 35% of whom die in the acute period. Recently, serious rejuvenation of cardiovascular disorders has been observed. The main reason for such trend is low patients’ compliance to drug therapy. And patients’ compliance itself allows significantly decreasing the risk of cardiovascular complications. The article discussed the issues of low compliance to drug therapy, presents the methods of its formation in patients from rural area. The examples of foreign and Russian experience of increasing patients’ compliance to drug therapy are described and the key intervention points for patients are determined. On the basis of conducted analysis, implementation was developed and suggested for patient-oriented program aimed at formation of adherence to drug therapy of rural population. Also, the authors performed evaluation of medical and economic efficiency of implementation of a patient-oriented program aimed at formation of adherence to drug therapy of rural population (assessment of expenditures for medications, hospital stay, incapacity related to the main disease; evaluation of expenditures for prevention of complications and disability).
Conclusion. Effective organization of prophylactic activity is of great importance for prevention of cardiovascular disease complications and directly affects population’s economic well being.
acute cerebrovascular accident / stroke / stroke education center / stroke prevention / morbidity / adherence / prognosis / medical and economic efficiency
| [1] |
Lopez A.D., Mathers C.D., Ezzati M. et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006; 367 (9524): 1747–1757. DOI: 10.1016/S0140-6736(06)68770-9. |
| [2] |
Lopez A.D., Mathers C.D., Ezzati M. et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006; 367 (9524): 1747-1757. DOI: 10.1016/S0140-6736(06)68770-9. |
| [3] |
Skvortsova V.I. The results of 3d Congress «Cerebrovascular pathology and stroke». Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Special issue. 2014; 114 (12): 3–8. (In Russ.) |
| [4] |
Скворцова В.И. Итоги III Конгресса «Цереброваскулярная патология и инсульт». Ж. неврол. и психиатрии им. С.С. Корсакова. Спецвыпуски. 2014; 114 (12): 3-8. |
| [5] |
Khasanova D.R. Care for patients with stroke: Tatarstan experience. Healthy Nation. 2016; (2): 48–49. (In Russ.) |
| [6] |
Хасанова Д.Р. Помощь больным с ОНМК: опыт Татарстана. Healthy Nation. 2016; (2): 48-49. |
| [7] |
Gil'manov A.A. Reasons and factors determining the need for changes in rural health care. Byulleten' Natsional'nogo nauchno-issledovatel'skogo instituta obshchestvennogo zdorov'ya im. N.A. Semashko. 2016; (3): 29–39. (In Russ.) |
| [8] |
Гильманов А.А. Причины и факторы, определяющие необходимость изменений в сельском здравоохранении. Бюлл. Нац. научно-исслед. ин-та общественного здоровья им. Н.А. Семашко. 2016; (3): 29-39. |
| [9] |
Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Zhurnal gipertonii. 2007; 25: 105–1187. (In Russ.) |
| [10] |
Рекомендации по лечению артериальной гипертонии 2007 года: Целевая группа по лечению артериальной гипертонии Европейского общества гипертонии (ЕОГ) и Европейского общества кардиологов (ЕОК). Ж. гипертонии. 2007; 25: 105-1187. |
| [11] |
Finegold J.A., Asaria P., Francisa D.P. Mortality from ischemic heart disease by country, region, and age: Statistics from World Health Organization and United Nations. Int. J. Cardiol. 2013; 168 (2): 934–945. DOI: 10.1016/j.ijcard.2012.10.046. |
| [12] |
Finegold J.A., Asaria P., Francisa D.P. Mortality from ischemic heart disease by country, region, and age: Statistics from World Health Organization and United Nations. Int. J. Cardiol. 2013; 168 (2): 934-945. DOI: 10.1016/j.ijcard.2012.10.046. |
| [13] |
Baranova E.I. Adherence to treatment of patients with arterial hypertension. How to correct the situation? Farmatsevticheskiy vestnik. 2010; (11): 27–32. (In Russ.) |
| [14] |
Баранова Е.И. Приверженность к лечению пациентов с артериальной гипертензией. Как исправить ситуацию? Фармацевтич. вестн. 2010; (11): 27-32. |
| [15] |
Claxton A.J., Cramer J., Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin. Ther. 2001; 23 (8): 1296–1310. DOI: 10.1016/S0149-2918(01)80109-0. |
| [16] |
Claxton A.J., Cramer J., Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin. Ther. 2001; 23 (8): 1296-1310. DOI: 10.1016/S0149-2918(01)80109-0. |
| [17] |
Bogatyreva M.D. Profilaktika ishemicheskogo insul'ta u sel'skogo naseleniya Stavropol'skogo kraya. (Prevention of ischemic stroke in rural population of Stavropol Krai.) PhD thesis: 14.01.11. Moscow: 2013; 141 p. (In Russ.) |
| [18] |
Богатырёва М.Д. Профилактика ишемического инсульта у сельского населения Ставропольского края. Диссертация канд. мед. наук: 14.01.11. М. 2013; 141 с. |
| [19] |
Kitaeva E.A., Kitaev M.R., Salyakhova L.Yu., Vafin A.Yu. Elaboration and implementation of the program for prevention of acute disorders of cerebral circulation as exemplified in Rybnaya Sloboda district of the Rebublic of Tatarstan. Kazanskiy meditsinskiy zhurnal. 2016; 97 (5): 764–770. (In Russ.) |
| [20] |
Китаева Э.А., Китаев М.Р., Саляхова Л.Ю., Вафин А.Ю. Разработка и внедрение программы профилактики острого нарушения мозгового кровообращения на примере Рыбно-Слободского района Республики Татарстан. Казанский мед. ж. 2016; 97 (5): 764-770. DOI: 10.17750/KMJ2016-764. |
| [21] |
Kitaeva E.A., Suetina T.A., Kitaev M.R. et al. Medical economic efficiency of creation of Diabetes educational center (as exemplified in Rybnaya Sloboda central regional hospital of the Rebublic of Tatarstan). Rossiyskoe predprinimatel'stvo. 2016; 17 (17): 2125–2138. (In Russ.) |
| [22] |
Китаева Э.А., Суетина Т.А., Китаев М.Р. и др. Медико-экономическая эффективность создания «Школы инсульта» (на примере центральной районной больницы Рыбно-Слободского района Республики Татарстан). Рос. предпринимательство. 2016; 17 (17): 2125-2138. DOI: 10.18334/rp.17.17. |
| [23] |
Diary of blood pressure self-monitoring. http://minzdrav.tatarstan.ru/file/Dnevnik%20samokontrolya_staryy%20variant(1).pdf (access date: 19.12.2016). (In Russ.) |
| [24] |
Дневник самоконтроля артериального давления. http://minzdrav.tatarstan.ru/file/Дневник%20самоконтроля_старый%20вариант(1).pdf (дата обращения: 19.12.2016). |
| [25] |
Supplement №1 to Government Resolution of RF issued at 26 Deember 2015. №2724. http://base.garant.ru/71296364/ (access date: 19.12.2016). (In Russ.) |
| [26] |
Приложение №1 к распоряжению Правительства РФ от 26 декабря 2015 г. №2724. http://base.garant.ru/71296364/ (дата обращения: 19.12.2016). |
| [27] |
ICH harmonized tripartite guideline: Guideline for Good Clinical Practice. Current Step 4 version dated 10 June 1996. Russ ed.: Rukovodstvo ICH po kachestvennoy klinicheskoy praktike (GCP). Transl. from Eng. Saint Petersburg: PSI Pharma Support Inc. 1997; 59 p. (In Russ.) |
| [28] |
Руководство ICH по качественной клинической практике (GCP). Пер. с англ. СПб.: PSI Pharma Support Inc. 1997; 59 с. |
| [29] |
Ostroumova O.D., Nedogoda S.V., Mamaev V.I., Shorikova E.G. Pharmakoeconomic apects of the treatment of essential arterial hypertension. Russkiy meditsinskiy zhurnal. 2002; (19): 866–870. (In Russ.) |
| [30] |
Остроумова О.Д., Недогода С.В., Мамаев В.И., Шорикова Е.Г. Фармакоэкономические аспекты лечения эссенциальной артериальной гипертонии. Русский мед. ж. 2002; (19): 866-870. |
| [31] |
Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Zhurnal gipertonii. 2013; 31 (7): 1281–1357. (In Russ.) |
| [32] |
Рекомендации по лечению артериальной гипертонии ЕОГ и ЕОК. Целевая группа по лечению артериальной гипертонии Европейского общества гипертонии (ЕОГ) и Европейского общества кардиологов (ЕОК). Ж. гипертонии. 2013; 31 (7): 1281-1357. |
| [33] |
Hilleman D.E., Mohiuddin S.M., Lucas Jr.B.D. et al. Cost-minimization analysis of initial antihypertensive therapy in patients with mild-to-moderate essential diastolic hypertension. Clin. Ther. 1994; 16 (1): 88–102. PMID: 7911403. |
| [34] |
Hilleman D.E., Mohiuddin S.M., Lucas Jr.B.D. et al. Cost-minimization analysis of initial antihypertensive therapy in patients with mild-to-moderate essential diastolic hypertension. Clin. Ther. 1994; 16 (1): 88-102. PMID: 7911403. |
| [35] |
Nelson E.C., Stason W.B., Neutra R.R., Solomons H.S. Identification of the noncompliant hypertensive patient. Prev. Med. 1980; 14: 504–517. DOI: 10.1016/0091-7435(80)90045-6. |
| [36] |
Nelson E.C., Stason W.B., Neutra R.R., Solomons H.S. Identification of the noncompliant hypertensive patient. Prev. Med. 1980; 14: 504-517. DOI: 10.1016/0091-7435(80)90045-6. |
Kitaeva E.A., Suetina T.A., Kitaev M.A., Bakirova E.A., Salyakhova L.Y., Vafin A.Y.
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