Prognosis of medical and economic efficiency of a patient-oriented program implementation aimed at formation of adherenceto drug therapy among rural population

Cover Page

Abstract


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.


E A Kitaeva

Author for correspondence.
kitaevaenge@mail.ru
Rybnaya Sloboda Central Regional Hospital Rybnaya Sloboda, Russia

T A Suetina

kitaevaenge@mail.ru
Kazan National Research Technical University named after A.N. Tupolev - Kazan Aviation Institute Kazan, Russia

M A Kitaev

kitaevaenge@mail.ru
Rybnaya Sloboda Central Regional Hospital Rybnaya Sloboda, Russia

E A Bakirova

kitaevaenge@mail.ru
Health center of JSC «Zelenodolsk plant named after A.M. Gorky» Zelenodolsk, Russia

L Ya Salyakhova

kitaevaenge@mail.ru
Kazan State Medical University Kazan, Russia

A Yu Vafin

kitaevaenge@mail.ru
Kazan State Medical University Kazan, Russia

  • 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.
  • 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.)
  • Khasanova D.R. Care for patients with stroke: Tatarstan experience. Healthy Nation. 2016; (2): 48–49. (In Russ.)
  • 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.)
  • 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.)
  • 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.
  • Baranova E.I. Adherence to treatment of patients with arterial hypertension. How to correct the situation? Farmatsevticheskiy vestnik. 2010; (11): 27–32. (In Russ.)
  • 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.
  • 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.)
  • 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.)
  • 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.)
  • Diary of blood pressure self-monitoring. http://minzdrav.tatarstan.ru/file/Dnevnik%20samokontrolya_staryy%20variant(1).pdf (access date: 19.12.2016). (In Russ.)
  • 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.)
  • 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.)
  • 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.)
  • 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.)
  • 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.
  • 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.

Views

Abstract - 24

PDF (Russian) - 10


© 2018 Kitaeva E.A., Suetina T.A., Kitaev M.A., Bakirova E.A., Salyakhova L.Y., Vafin A.Y.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Свидетельство о регистрации СМИ ЭЛ № ФС 77-70434 от 20 июля 2017 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)