Saratov JOURNAL of Medical and Scientific Research

Akulova A.I.

Saratov State Medical University n.a. V. I. Razumovsky Department of Hospital Therapy of Medical Faculty, Postgraduate

Rheumatology profile patients adherence to treatment with non-steroidal anti-inflammatory drugs

Year: 2020, volume 16 Issue: №1 Pages: 99-103
Heading: Sociology of Medicine Article type: Original article
Authors: Smotrova Yu.N., Novokreshchenova I.G., Akulova A.I.
Organization: Saratov State Medical University
Summary:

The aim of the study is to assess the degree of adherence of patients with rheumatic diseases to the treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Material and Methods. 196 patients were surveyed using a specially designed questionnaire, which included Morisky — Green test. Statistical data processing was carried out by methods nonparametric statistics (criterion x2)- Results. Patients took NSAIDs in rheumatoid arthritis (50.0%), ankylosing spon-dylitis (37.8%), vertebrogenic dorsalgia (20.4%). 49.0% of patients took NSAIDs constantly, 39.3% — during courses of treatment, 11.7% — on demand (in pain). 81.1 % of patients were engaged in self-treatment of NSAIDs. 20 patients (10.2%) were adherent to the treatment of NSAIDs, 29 patients (14.8%) were insufficiently adherent (patients were united in one group), 147 patients (75.0%) were not adherent to the treatment. Non-adherent patients mostly violated the regimen of treatment if they felt well (85.7%). For adherent patients the most significant motive was deterioration after taking NSAID (20.4%). Adherent patients mostly had higher education in relation to non-adherent (71.4 and 53.7% respectively) (x2=6.647; p<0.05). Side effects of NSAIDs were absent in 73.5% of adherent patients and in 32,0% of non-adherent (x2=24.795; p<0.01). Conclusion. The level of education, the frequency of side effects and subjective assessment of the patient's state of health affect the degree of adherence of patients with rheumatic diseases to the treatment of NSAIDs.

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Remote monitoring in patients with spondylitis

Year: 2014, volume 10 Issue: №2 Pages: 314-317
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Akulova A.l., Gaydukova I.Z.
Organization: Saratov State Medical University
Summary:

Objective: to evaluate the adherence to therapy and treatment outcomes in patients with spondylitis (SpA) in which activity of the disease managed remotely. Material and Methods. 193 patients with axial SpA were randomized into 3 groups with the different ways of the disease activity monitoring: 96 patients were managed in free way, 26 patients visited rheumatologist every 12 weeks, 69 patients managed remotely — we called them every 4 weeks. After the first year of follow up we made 3-month break in the telephone monitoring. The data on the treatment and SpA activity (indexes BASDAI, PASS, ESR, CRP) were collected. Results. In patients managed in a free way SpA activity was severe after a year. In groups managed remotely and once in 3 month the significant reduction in the disease activity was achieved with maximal decrease in remote monitoring group. Positive PASS group 3 was found in 15 patients (57.69%, n=26), in group 2 — in 4 patients (20%, n=20), in group 1 — no patients (0%). NSAIDs intake was arbitrarily changed by 5 (19.23%, n=26), 15(75%, n=20), and 93(96.87%, n=96) patients of groups 3, 2 and 1, respectively. After a 3- month break in remote monitoring in 13 patients with initial BASDAI>4 disease activity significantly increased, in 33 patients with BASDAK4 disease activity decreased. 17 (51.5%) patients independently changed the drug intake regimen after the break in monitoring. Conclusion. Remote monitoring is associated with better adherence to therapy and the best results of treatment of patients with SpA than the other modes of observation. Remote monitoring frequency must be determined individually.

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