Compliance to clinician prescriptions in ischemic heart disease patients (by the data from outpatient registry PROFILE)

Abstract

Aim. Based on the data of outpatient registry PROFILE, with addition of questionnaires, to analyze treatment compliance and influencing factors, in coronary heart disease (CHD) patients. Material and methods. 688 patients of the PROFILE registry who had come to a primary visit in scientific department of the investigation center at time between 1 January 2014 to 31 August 2015, were asked to complete an original compliance to clinician prescriptions (CP) questionnaire with integrated Morisky-Green test (MG). It was filled by 479 patients (70,1%). In 250 of answerers there was CCHD: 65 women (26%) and 175 men (74%). Mean age of CCHD patients was 63,6±12,5 y. o. 72,1% of them in the PROFILE registry, had higher education, 16 (6,4%) - scientific degree. Diagnosis of CHD was verified as anamnesis of myocardial infarction (MI), coronary arteriography (CAG) or exercise test in 231 (92,4%) participants. Results. As the patients charts show, 12 patients with CCHD from 250 participants did not receive any medication treatment, 15 took medications irregularly, and other 223 regularly, by CP. This data is confirmed by the results of original questionnaires: 193 patients responded that do strictly adhere all CP on medications, and 49 (among 238) - had misused some prescriptions. By the results of 4-unit MG test, only 47 from 230 of responders were completely adherent to the treatment, and other 71 made at least one positive response, being relatively adherent. In multifactorial logistic regression, it was found that stable angina and scientific degree do increase adherence 3 times (p=0,006; OR 2,9; CI 95% [1,4;6,0]) and more than 6 times, respectively (p=0,003; OR=6,3; CI 95% [1,9;21,0]). Also, it was shown that treatment adherence (by our original questionnaire) depends on the regularity of clinician follow-up, and office visits once per year and more do increase it more than 5 times (p=0,019, OR=5,1 CI 95% [1,3;19,9]). Conclusion. Clinical symptoms of CHD (stable angina), scientific degree, as well as regular clinician follow-up at least once per year, are the factors increasing overall patients adherence to CP and medication treatment compliance.