DYNAMIC OBSERVATION DOES NOT CREATE CONDITIONS TO IMPROVE THE COMPLIANCE TO TREATMENT AND EFFICIENCY OF PHARMACOTHERAPY IN RETIRED PATIENTS WITH ARTERIAL HYPERTENSION
Abstract
To substantiate the need for involvement and format of the participation of a pharmacist in the process of forming in patients compliance to drug therapy prescribed by a doctor in order to increase the effectiveness of treatment of retired patients with arterial hypertension.
Material and methods
This article presents the results obtained during the implementation of the stage of dynamic observation, which is a part of a three-phase study of compliance to treatment of elderly patients with arterial hypertension, and does not provide special measures to improve patients’ compliance.
Recruitment of retired patients with arterial hypertension at the stage of dynamic observation was carried out in a pharmacy, where a special room (center of pharmaceutical care) was organized. The pharmacist offered the elderly pharmacy visitors to participate in a study on self-monitoring of treatment.
After signing an informed consent, the level of compliance was determined by the Moriska-Green test. Later on, patients were asked to visit a cardiologist to clarify the diagnosis and evaluate the antihypertensive drug therapy taken according to the patient’s clinical status.
All participants in the dynamic observation program were consulted by a pharmacist on the acquisition of an antihypertensive drug prescribed by a doctor. The cardiologist prescribed drugs according to international names. The pharmacist explained the possibility of interchangeability of drugs from different manufacturers, discussed the cost of purchased drugs.
In prospect, visits of patients to the pharmacist to the center were carried out at the 4th and 8th weeks of participation in the program of dynamic observation. During the visits, the level of compliance to treatment was determined by the Moriska-Green test and the effectiveness of antihypertensive therapy (blood pressure measurement) was evaluated.
Results and discussion
Patients (n = 51) who participated in the dynamic observation stage were represented by men (n = 25; 49.0%) and women (n = 26 people; 51.0%) aged from 62 to 75 years (average age males 67.2 ± 0.9; females 67.7 + 0.9).
The results obtained demonstrate the initial low compliance to treatment of elderly patients with arterial hypertension: the result according to the Moriska-Green test was 2.4 ± 0.1. Antihypertensive pharmacotherapy in this cohort of patients is ineffective: the level of systolic blood pressure is 168.9 ± 1.5 mm Hg. and diastolic – 106.6 ± 1.5 mm Hg.
Dynamic observation of patients does not provide an improvement of the analyzed parameters, which remain at the same level after eight weeks: the result of the Moriska-Green test is 2.4 ± 0.1; the level of systolic blood pressure is 167.0 ± 1.4 mm Hg and diastolic – 105.0 ± 1.4 mm Hg.
Conclusion
Dynamic patient monitoring does not provide improved compliance rates for patients with arterial hypertensive disease and the effectiveness of antihypertensive pharmacotherapy. In order to achieve proper compliance to treatment of elderly hypertensive patients, it is necessary to conduct additional discussions about the importance of compliance to treatment of antihypertensive drugs by patients, constant monitoring of the effectiveness of drug therapy in terms of blood pressure. Such work with patients can be carried out by a pharmacist at the center of pharmaceutical care that we have created.
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