Comparative analysis of adherence to treatment in patients with various forms of coronary heart disease

The problem of adherence to treatment of patients with coronary artery disease currently requires an integrated approach, as it is socially significant. Despite a wide range of drugs, adherence to therapy remains low, which leads to an increase in the frequency of hospitalizations and acute coronary events. In this connection, it is necessary to search for new ways to increase the level of compliance in patients with coronary artery disease. The aim was to compare the level of adherence to treatment in patients with an unstable and stable form of angina pectoris. The study of compliance involved 220 patients with a verified diagnosis of coronary artery disease, according to clinical recommendations, in accordance with the principles of the Helsinki Declaration. To assess the level of compliance, the questionnaire R. V. Kadyrov was used. It was found that the main form of coronary heart disease in the examined patient population was an unstable form of angina pectoris, regardless of gender and age. The study of gender characteristics showed that men were significantly more likely to suffer from an unstable form of angina pectoris. The level of general compliance was high in patients of both groups, while social, emotional and behavioral adherence to treatment was significantly lower in patients with unstable angina, regardless of gender and age. There was a direct correlation between overall compliance and disease duration in all patients with coronary artery disease, regardless of gender and age, which can be regarded as a poor prognostic sign for assessing the effectiveness and course of coronary artery disease. Compliance should be assessed not only by the general level of compliance, but also taking into account certain types of adherence to treatment and biological factors. At present, one of the important components is the assessment of behavioral compliance, which, in our opinion, should be supplemented by the cognitive and communicative component of the personality.

1. World Health Organization. News bulletin. May 17, 2017 https://www.who.int/en/news-room/factsheets/detail/cardiovascular-diseases(cvds).

2. Demographic Yearbook of Russia. 2021. Stat. sb. Rosstat. M., 2021.

3. Clinical, morphological and statistical classification of coronary heart disease. Consensus of the Russian Society of Cardiology, the Russian Society of Pathologists and Specialists in Medical Statistics. Available at: https://scardio.ru/content/Guidelines/Klass_IBS_2020.pdf.

4. Ministry of Health of Russian Federation. Clinical recommendations. Stable coronary heart disease. 2020. Available at: https://scardio.ru/content/Guidelines/2020/Clinic_rekom_IBSunlocked.pdf.

5. Kadyrov R. V., Asriyan O. B., Koval'chuk S. A. Questionnaire "Compliance Level" [Tekst]: monografiya. Vladivostok: Mor. gos. un-t, 2014. P. 74.

6. Nebiyeridze D. V., Kamyshova T. V., Safaryan A. S. i dr. Adherence to therapy as an integral part of the treatment of cardiac diseases // kardiovaskulyarnaya terapiya i profilaktika. 2017; 16 (6); 128-132.

7. Oganov R. G., Boytsov S. A., Ageyev F. T. i dr. National recommendations for cardiovascular prevention // Kardiovaskulyarnaya terapiya i profilaktika. 2011. T.10. № 6. Prilozheniye 2. P. 528.

8. Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C., et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes // European Heart Journal. 2020; 41 (3): 407-477. https://doi.org/10.1093/eurheartj/ehz425.

9. Mathias I. S., Riaz H. ISCHEMIA Trial: A Hope or a Hype for Patients with Stable Coronary Artery Disease? // The American Journal of Medicine. 2019; S0002934319310800. [Epub ahead of print]. https://doi.org/10.1016/j.amjmed.2019.11.010.

10. Montalescot G., Sechtem W., Achenbach S., Andreotti F., Arden C., Budaj A., et al. 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology // European Heart Journal. 2013; 34 (38): 2949-3003. https://doi.org/10.1093/eurheartj/eht296.

11. Anderson L., Brown J. P., Clark A. M. and other. Patient education in the management of coronary heart disease // Cochrane Database Syst em Rev. 2017; 6: CD008895. http:// dx.doi. org / 10.1002/14651858.CD008895.pub3.

12. Nagibina Yu. V., Zakharova L. A. Medical and social characteristics of patients with coronary heart disease and quality of life // Rossiyskiy kardiologicheskiy zhurnal. 2017 3 (143): 155. http://dx.doi.org/10.15829/1560-4071-2017-3-155-159.

13. Douglass E., Greif S., Frishman W. H. Epicardial Fat: Pathophysiology and Clinical Significance // Cardiology in Review. 2017; 25 (5): 2305. https://doi.org/10.1097/CRD.0000000000000153.

14. Morrow A., Sidik N., Berry C. ISCHEMIA: new questions from a landmark trial // Cardio vascular Research. 2020; 116 (2): e235. https://doi.org/10.1093/cvr/cvz343.

15. Fox K. A. A., Metra M., Morais J., Atar D. The myth of ‘stable’ coronary artery disease // Nature Reviews Cardiology. 2020; 17 (1): 921. https://doi.org/10.1038/s 41569-19-0233-y.

16. Declaration of Helsinki of the World Medical Association. http://actorussia.org/index.php?option=com_content&task=view&id=21&ysclid=l96xs2kud4404434842.