Science & Healthcare

Aim of research – to analyse influence of social-economical, clinical and pharmaco-epidemiological factors to patients’s compliance on the treatment in population of East Kazakhstan.

Materials and methods: Study design – cross-sectional study. The study included 2346 patients with arterial hypertension aged 25 to 80 years, including 1281 men (54,6%) and 1065 women (45,4%). The average age is 55,2 ± 1,1 years.

Carried out estimation of compliance to medical therapy at patients with arterial hypertension. Depending on the degree of compliance, estimated patients divided on three groups: «no compliance»; «partial»; «full». As factors influencing on compliance, considered: gender; age; economic status; the degree of BP increase (including the option of isolated systolic hypertension); the presence of complications from the heart and blood vessels; presence of concomitant diseases (IHD, diabetes mellitus); a variant of drug therapy.

Results: Complete compliance to drug therapy defined in 41,1% of cases, lack of commitment - in 26,9% of cases. The lowest compliance was determined in young people (25-40 years old) - the differences with the mean for the whole group were significant (for complete compliance in men, p=0.003).

A high level of compliance was determined in patients with AH III degree, it significantly exceeded the corresponding index in all other groups in terms of the degree of BP increase. In the presence of concomitant IHD, diabetes, and their combinations, full compliance was observed significantly more often than in the absence (IHD - p <0,001, diabetes - p = 0,003). A high indicator of total compliance defined in people who underwent myocardial infarction. Differences with patients who did not have a history of AH complications were significant (p<0,001). A significant excess was revealed by the indicator of total compliance in individuals with a high and satisfactory economic status over a subgroup with a low (p = 0,002, p = 0,001). The highest frequency of complete compliance was determined with the use of fixed combinations of antihypertensive drugs. Then sequentially monotherapy beta-blockers, calcium antagonists, a combination of separate dosage forms, AIR, angiotensin receptor blockers. Lower rates of complete compliance found in ACE inhibitors, diuretics, drugs of other pharmacological groups. The role of the variant of drug therapy in the formation of compliance is most pronounced in arterial hypertension III st. and ISAH.

Conclusion:

Extent of increase blood pressure was the major factor defining commitment to medicamentous pharmacotherapy of arterial hypertension. The role of economic factor and the accompanied diseases was moderate.

The greatest influence on compliance provided by the option of ongoing medical therapy.

The best results obtained with the use of fixed combinations of drugs.