COMORBIDITY AND ITS MPACT ON THE ADHERENCE TO FURTHE RTREATMENT IN PATIENTS WITH MYOCARDIAL INFARCTION
DOI:
https://doi.org/10.11603/2415-8798.2018.2.9199Keywords:
comorbidity, myocardial infarction, adherence to treatment, Compliance, Charlson Comorbidity Index, CIRS comorbidity index.Abstract
In modern clinical practice, the doctor is increasingly faced with a combination of two or more diseases in one patient. Such states are called comorbid, concomitant pathologies, or associated diseases [1–3]. This is especially true for patients with myocardial infarction (MI), since cardiovascular disease (CVD ) remains one of the main causes of death in Ukraine and in the world (World Heart Federation, WH F, 2017).
The aim of the study – to set the frequency and the structure of comorbidity in patients with myocardial infarction (IM) and its effect on adherence to further treatment.
Materials and Methods. We examined 152 patients with MI, aged 38 to 89 years, on average (60.66±0.86) years (52 women and 100 men) who were divided according to the Morisky-Green questionnaire by two groups: the first – adherent to treatment (n=77), the second group – not adherent to treatment (n=75). The Charlson and CIRS comorbidity indices were determined.
Results and Discussion. Both groups identified risk factors and 84% of the concomitant pathology, with the Charleston index – (5.81±1.78), and CIRS (9.32±2.79) points, the largest proportion of diseases of the digestive system. When comparing between groups for the same amount of comorbid pathology (5.66±0.19) and (5.96±0.24) points of Charlson, p<0.05) in patients in the second group a heavier course with deeper damage to organs and systems (CIRS – (8.23±0.25) versus (10.43±0.34) points, p<0.001), which reduces the level of adherence to the prescribed therapy.
Conclusions. Patients with myocardial infarction often have a comorbidity, but with the same number of concomitant diseases in different patients, the severity and depth of damage to organs and systems are different. The present combined pathology has an effect on adherence to therapy. Determining the Charlson and CIRS indices allows you to predict the level of compliance individually for each patient and take measures to increase its level.
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