Gaisenok Oleg, Martsevich Sergey, Tripkosh Svetlana, Lukina Yulia
FGBI "National Research Centre of Preventive Medicine" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia; FGBI "Joint Hospital and Polyclinic" Department of Presidential Affairs of the Russian Federation, Moscow, Russia.
FGBI "National Research Centre of Preventive Medicine" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia; IM. Sechenov First Moscow State Medical University, Moscow, Russia.
Rev Port Cardiol. 2015 Feb;34(2):111-6. doi: 10.1016/j.repc.2014.08.021. Epub 2015 Feb 3.
The aim of this study was to analyze the quality of lipid-lowering therapy in a cohort of patients with cardiovascular disease enrolled in a Moscow-based registry, and to analyze the factors affecting the regularity of statin administration in this patient category.
The present study included all patients who successively sought medical advice in the Preventive Pharmacotherapy Department of the Ministry of Healthcare of the Russian Federation between May 1 and December 31, 2011 (n=274). Each patient was given a specially designed questionnaire in order to assess compliance with the prescribed treatment that included the following questions: (1) if they knew, according to the results of previous exams, that they had elevated cholesterol levels (yes, no, don't know); (2) what method of hypercholesterolemia correction they used (diet, medication, physical exercise, or other); (3) if they were taking any statins (regularly, no, irregularly); and (4) if yes, what statin preparation and what dose they were taking. Patients' compliance with statin therapy was assessed on the basis of the responses received and the regularity of statin intake.
The influence of various factors on regularity of statin intake in patients with cardiovascular disease was assessed by calculating odds ratios (OR) and 95% confidence intervals (CI) for advanced age (>70 years) (OR 0.49); higher statin dose than standard (OR 0.49); hypertension (OR 1.659); history of acute cerebrovascular event (OR 2.019); diabetes (OR 1.023); coronary heart disease (CHD) (OR 4.357); history of myocardial infarction (MI) (OR 4.838); history of coronary angiography/percutaneous coronary intervention (PCI) (OR 5.167).
Analysis of factors with impact on regular compliance with statin therapy showed that the following were most significant: CHD, history of MI, and history of PCI. Previous cerebrovascular events and presence of diabetes did not motivate these patients to take statins on a regular basis.
本研究旨在分析纳入莫斯科某登记处的一组心血管疾病患者的降脂治疗质量，并分析影响该类患者他汀类药物给药规律的因素。
本研究纳入了2011年5月1日至12月31日期间在俄罗斯联邦卫生部预防性药物治疗科先后就诊的所有患者（n = 274）。为每位患者提供了一份专门设计的问卷，以评估其对规定治疗的依从性，问卷包括以下问题：（1）根据之前的检查结果，他们是否知道自己胆固醇水平升高（是、否、不知道）；（2）他们采用了哪种高胆固醇血症纠正方法（饮食、药物、体育锻炼或其他）；（3）他们是否正在服用任何他汀类药物（规律服用、否、不规律服用）；以及（4）如果是，他们正在服用哪种他汀类制剂以及剂量是多少。根据收到的回答和他汀类药物摄入的规律评估患者对他汀类药物治疗的依从性。
通过计算高龄（>70岁）（比值比[OR] 0.49）、高于标准剂量的他汀类药物（OR 0.49）、高血压（OR 1.659）、急性脑血管事件病史（OR 2.019）、糖尿病（OR 1.023）、冠心病（CHD）（OR 4.357）、心肌梗死病史（MI）（OR 4.838）、冠状动脉造影/经皮冠状动脉介入治疗（PCI）病史（OR 5.167）的比值比（OR）和95%置信区间（CI），评估了各种因素对心血管疾病患者他汀类药物摄入规律的影响。
对影响他汀类药物治疗规律依从性的因素分析表明，以下因素最为显著：冠心病、心肌梗死病史和PCI病史。既往脑血管事件和糖尿病的存在并未促使这些患者规律服用他汀类药物。
