Methods for improving of secondary cardiovascular prevention in patients after acute coronary syndrome
https://doi.org/10.26295/OS.2020.65.55.019
Abstract
In 2015, in order to increase patient commitment to taking life-saving drugs, the state program of the Omsk Region «Development of Health Care in the Omsk Region» was developed and introduced in terms of preferential drug provision with acetylsalicylic acid, clopidogrel, and atorvastatin. Based on the results of the implementation of this event, a clinical expert analysis of the effectiveness of dispensary observation was carried out, the routing of patients between the hospital and the clinic was improved and implemented. Based on the proposed technologies, an improved program was again implemented in 2018, the effectiveness of which in terms of the commitment of doctors to clinical recommendations and patients to follow-up was the subject of this study to scientifically substantiate ways to improve secondary cardiovascular prophylaxis.
Against the background of improved patient routing between hospitals and clinics, modernization of free drug provision and development of unified templates of medical records to prevent errors in the management of patients who have undergone acute coronary syndrome and x-ray endovascular intervention on the coronary artery, increased adherence of doctors to current clinical recommendations, and patients to dispensary monitoring, as ways to improve secondary cardiovascular prevention.
About the Authors
S. P. Podolnaya
Omsk State Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Omsk
O. Yu. Korennova
Budgetary Healthcare Institution of the Omsk Region «City Clinical Cardiological Dispensary»
Россия
Россия
Doctor of Medicine, Professor,
Omsk
L. V. Shukil
Omsk State Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Doctor of Pharmaceutics,
Omsk
E. A. Ryapolova
Omsk State Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
PhD in Medicine,
Omsk
I. V. Druk
Omsk State Medical University of the Ministry of Health of the Russian Federation
Россия
Россия
Doctor of Medicine, Professor,
Omsk
References
1. Ageyeva L. I. Zdravookhraneniye v Rossii. [Healthcare in Russia] 2017: statistichesky sbornik. Moskva: Rosstat, 2017, 170. (In Russ.).
2. Boyko V. P. Regionalnaya programma Omskoy oblasti «Borba s serdechnososudistymi zabolevaniyami» na 2019–2024 gody. [The regional program of the Omsk region «Combating cardiovascular diseases» for 2019–2024.] (In Russ.).
3. Gudinova Zh. V., Usacheva Ye. V, Berezhnoy K. O. Zabolevayemost infarktom miokarda v Rossyskoy Federatsii, Sibirskom federalnom okruge i Omskoy oblasti [Myocardial infarction incidence in the Russian Federation, Siberian Federal District and Omsk Region] Problemy sotsialnoy gigiyeny, zdravookhraneniya i istorii meditsiny. 2018, 6 (26): 397–400. (In Russ.).
4. Gerasimov A. A., Polibin R. V., Mindlina A. Ya. Priverzhennost vrachey ambulatorno-poliklinicheskoy organizatsii klinicheskim rekomendatsiyam pri provedenii profilaktiki povtornogo infarkta miokarda. Epidemiologiya i infektsionnye bolezni [The commitment of outpatient physicians to clinical guidelines for the prevention of myocardial infarction. Epidemiology and Infectious Diseases] Aktualnye voprosy. 2017; 3: 25–30. (In Russ.).
5. Pogosova N. V., Oganov R. G., Boytsov S. A., Ausheva A. K., Sokolova O. Yu., Kursakov A. A. i dr. Monitoring vtorichnoy profilaktiki ishemicheskoy bolezni serdtsa v Rossii i Yevrope: rezultaty rossyskoy chasti mezhdunarodnogo mnogotsentrovogo issledovaniya EUROASPIRE IV [Monitoring secondary prevention of coronary heart disease in Russia and Europe: results of the Russian part of the international multicenter study EUROASPIRE IV] Kardiologiya. 2015; 55 (12): 99–107. (In Russ.).
6. Kotseva K., Wood D., G. De Backer EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries // Eur. J. Cardiovasc. Prev. Rehabil. 2009, 16 (2): 121–137.
7. Nazzal C., Lanas F, Garmendia M. L. Secondary prevention in acute myocardial infarction in Chile // J Epidemiol Community Health. 2011; 65. Suppl. № 1 (poster session 2). 281–282.
8. Shukil L. V., Korennova O. Yu. Farmakoekonomicheskoye obosnovaniye medikamentoznogo obespecheniya atsetilsalitsilovoy kislotoy, klopidogrelom, atorvastatinom patsiyentov, perenesshikh rentgenendoaskulyarnyye vmeshatel’stva na koronarnykh sosudakh po povodu ostrogo koronarnogo sindroma [Pharmacoeconomic rationale for providing the patients undergoing endovascular coronary intervention for acute coronary syndrome with medical acetylsalicylic acid, clopidogrel, atorvastatin] Trudny patsiyent. 2015, 10–11 (13): 14–17. (In Russ.).
9. Postanovleniye Pravitelstva Omskoy oblasti ot 24 dekabrya 2014 goda № 330-p «O Territorialnoy programme besplatnogo okazaniya meditsinskoy pomoshchi grazhdanam v Omskoy oblasti na 2015 god i planovy period 2016 i 2017 godov». [Decree of the Government of the Omsk Region dated December 24, 2014 No. 330-p “On the Territorial Program for the free provision of medical care to citizens in the Omsk Region for 2015 and the planning period 2016 and 2017”] (In Russ.).
10. Postanovleniye Pravitelstva Omskoy oblasti ot 27 iyunya 2018 goda № 172-p «O vnesenii izmeneny v postanovleniye Pravitelstva Omskoy oblasti ot 16 oktyabrya 2013 goda № 265-p». [Resolution of the Government of the Omsk Region dated June 27, 2018 No. 172-p “On Amending the Resolution of the Government of the Omsk Region dated October 16, 2013 No. 265-p”.] (In Russ.).
11. Boytsov S.A. Kardiovaskulyarnaya profilaktika 2017. Rossyskiye natsionalnye rekomendatsii [Cardiovascular Prevention 2017. Russian National Recommendations] Rossysky kardiologichesky zhurnal. 2018, 23 (6): 7–122. (In Russ.).
12. Prikaz Ministerstva zdravookhraneniya Rossyskoy Federatsii ot 15 noyabrya 2012 g. № 918n «Ob utverzhdenii Poryadka okazaniya meditsinskoy pomoshchi bolnym s serdechno-sosudistymi zabolevaniyami». [Order of the Ministry of Health of the Russian Federation of November 15, 2012 No. 918n “On approval of the Procedure for the provision of medical care to patients with cardiovascular diseases”] KonsultantPlyus (In Russ.).
13. Federalny Zakon RF № 323-FZ «Ob osnovakh okhrany zdorovya grazhdan Rossyskoy Federatsii». [Federal Law of the Russian Federation No. 323-FZ “On the Basics of Protecting the Health of Citizens of the Russian Federation”.] KonsultantPlyus (In Russ.).
14. Boytsov S. A., Luk’yanov M. M., Yakushin S. S. Registr kardiovaskulyarnykh zabolevaniy (REKVAZA): diagnostika, sochetannaya serdechno-sosudistaya patologiya, soputstvuyushchiye zabolevaniya i lecheniye v usloviyakh real’noy ambulatorno-poliklinicheskoy praktiki // Kardiovaskulyarnaya terapiya i profilaktika. [Cardiovascular diseases registry (RECVAZA): diagnostics, concomitant cardiovascular pathology, comorbidities and treatment in the real outpatient-polyclinic practice] // Cardiovascular Therapy and Prevention. 2014; 13 (6): 44–50. (In Russ.) https://doi.org/10.15829/1728-8800-2014-6-3-8.
15. Oganov R. G., Lepakhin V. K., Fitilev S. B., Levin A. M., Shkrebneva I. I., Titarova Yu. Yu, VozzhaevA. V. Otsenka vypolneniya rekomendatsiy po vtorichnoy profilaktike serdechno-sosudistykh zabolevaniy u patsiyentov, perenesshikh infarkt miokarda (farmakoepidemiologicheskoye issledovaniye) [Assessing the implementation of the recommendations on secondary cardiovascular prevention in patients after myocardial infarction (a pharmacoepidemiologic study)] // Kardiovaskulyarnaya terapiya i profilaktika. 2009; 8 (4). (In Russ.).
16. ESC/EAS Guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) // European Heart Journal. 2020; 41 (1): 111–188. https://doi.org/10.1093/eurheartj/ehz455.
17. Erlih A. D., Barbarash O. L., Kashtalap V. V., Gracianskij N. A. Stepen’ sledovaniya klinicheskim rukovodstvam pri ostrom koronarnom sindrome bez pod»ema ST: svyaz’ s iskhodami, prediktory «plohogo» lecheniya (rezul’taty registra «Rekord-3») [The degree of adherence to clinical guidelines for acute coronary syndrome without ST elevation: association with outcomes, predictors of “poor” treatment (results of the “Record-3” register). Complex problems of cardiovascular diseases.] Kompleksnye problemy serdechno-sosudistyh zabolevanij. 2016; 2: 75–82. (In Russ).
18. Ruda M. Y., Averkov O. V., Khomitskaya Y. V. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in Russia: an observational study (EPICOR-RUS study) // Curr. Med Res. Opin. 2017, 33 (7): 1269–1276.
19. Wallentin L., Becker R. C., Budaj A., et al. for the PLATO Investigators. Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes // N. Engl. J. Med. 2009; 361: 1045–1057. 20. World Health Organization/ http://www.who.int/cardiovascular_diseases/priorities/secondary_prevention/country/en/index1.html
20. Davidovich I. M., Malay L. N., Kutishenko N. P. Otdalennyye rezul’taty i priverzhennost’ terapii u patsiyentov posle ostrogo infarkta miokarda: dannyye registra (Khabarovsk) [The analysis of long-term outcomes and adherent to treatment in patients after myocardial infarction: khabarovsk register data] The Clinician. 2017; 11 (1): 36–44. (In Russ.) https://doi.org/10.17650/1818- 8338-2016-10-4-36-44.
21. Bershtein L. L., Zbyshevskaya E. V., Katamadze N. O., KuzminaKrutetskaya A. M., Volkov A. V., Andreeva A. E., Gumerova V. E., Bitakova F. I., Sayganov S. A. ISCHEMIA — krupneysheye v istorii randomizirovannoye issledovaniye po stabil’noy ishemicheskoy bolezni serdtsa. Iskhodnyye kharakteristiki vklyuchennykh patsiyentov na primere rossiyskogo tsentra [ISCHEMIA — the Largest Ever Randomized Study in Stable Coronary Artery Disease. Baseline Characteristics of Enrolled Patients in One Russian Site] // Kardiologiia. 2017; 57 (10): 12–19. (In Russ.) https://doi.org/10.18087/cardio.2017.10.10038.
22. Postanovleniye Pravitelstva RF ot 30.11.2019 g. № 1569 «O vnesenii izmeneny v gosudarstvennuyu programmu Rossyskoy Federatsii «Razvitiye zdravookhraneniya», v chasti obespecheniya lits, nakhodyashchikhsya na dispansernom nablyudenii, perenesshikh v period s 1 yanvarya 2020 goda infarkt miokarda, a takzhe kotorym byli vypolneny aortokoronarnoye shuntirovaniye, angioplastika koronarnykh artery so stentirovaniyem i kateternaya ablyatsiya po povodu serdechno-sosudistykh zabolevany, lekarstvennymi preparatami v ambulatornykh usloviyakh». [Decree of the Government of the Russian Federation of November 30, 2019 No. 1569 «On Amending the State Program of the Russian Federation» Development of Health Care», in terms of providing people under medical supervision who had myocardial infarction from January 1, 2020, as well as those who performed coronary artery bypass grafting, angioplasty of coronary arteries with stenting and catheter ablation for cardiovascular diseases, drugs on an outpatient basis».] Konsultant Plus.
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For citations:
Podolnaya S.P., Korennova O.Yu., Shukil L.V., Ryapolova E.A., Druk I.V. Methods for improving of secondary cardiovascular prevention in patients after acute coronary syndrome. Lechaschi Vrach. 2020;(7):21-27. (In Russ.) https://doi.org/10.26295/OS.2020.65.55.019
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