Mbaye A, Koukaba Ntontolo F L, Diomou A F, Bodian M, Ndiaye M B, Kane Ad, Yaméogo N V, Pessinaba S, Sarr S A, Dioum M, Thiam A, Hakim R, Diao M, Kane A
Service de cardiologie, faculté de médecine, pharmacie et odontologie, université Cheikh Anta DIOP de Dakar, hôpital général de Grand Yoff de Dakar, BP 3270 Dakar, Sénégal.
Ann Cardiol Angeiol (Paris). 2013 Feb;62(1):17-21. doi: 10.1016/j.ancard.2011.07.001. Epub 2011 Aug 17.
The management of coronary artery disease has made important progress. Adherence to therapeutic measures is a great challenge for improving the long-term prognosis. In this work, we evaluate factors related to therapeutic adherence in black African patients with stable coronary artery disease.
We conducted a survey over three months (February-May 2008) in three cardiology departments in Dakar. We studied the regularity of drug intake, the adherence to the dietary advices and the appointments for consultation as well as the factors related to adherence. Good adherence was defined by a compliance rate greater or equal to 80% and a compliance rate less than 40% defined poor adherence.
We included 105 patients (61 men) with a mean age of 60.67±11.29 years. Good compliance was noted in 56.2% of cases for drug treatment, 42% for dietary advices and 65% for appointments for consultation. A history of acute coronary events (P=0.04), a good knowledge of the disease (P=0.03) and a healthcare (P=0.02) were the factors related to a good adherence to drug treatment, whereas ischemic cardiomyopathy was a factor for poor adherence (P=0.002). Knowledge of coronary disease was the only factor correlated with good adherence to lifestyle (P=0.014).
Therapeutic adherence remains unsatisfactory in Black African patients with stable coronary artery disease, hence the importance of patient education to reach a good adherence for therapeutic, because better adherence improves long-term prognosis of coronary artery disease.
冠状动脉疾病的管理已取得重要进展。坚持治疗措施对改善长期预后是一项巨大挑战。在本研究中，我们评估了非洲黑人稳定型冠状动脉疾病患者治疗依从性的相关因素。
我们于2008年2月至5月在达喀尔的三个心脏病科进行了为期三个月的调查。我们研究了药物摄入的规律性、对饮食建议的依从性、就诊预约情况以及与依从性相关的因素。良好依从性定义为依从率大于或等于80%，依从率小于40%定义为依从性差。
我们纳入了105例患者（61例男性），平均年龄为60.67±11.29岁。药物治疗的良好依从率为56.2%，饮食建议的依从率为42%，就诊预约的依从率为65%。急性冠状动脉事件病史（P=0.04）、对疾病的良好认知（P=0.03）和医疗保健（P=0.02）是与药物治疗良好依从性相关的因素，而缺血性心肌病是依从性差的一个因素（P=0.002）。对冠状动脉疾病的认知是与良好生活方式依从性相关的唯一因素（P=0.014）。
非洲黑人稳定型冠状动脉疾病患者的治疗依从性仍然不尽人意，因此患者教育对于实现良好的治疗依从性很重要，因为更好的依从性可改善冠状动脉疾病的长期预后。
