Adherence to treatment among the military personnel with coronary artery disease
The purpose. To conduct a comprehensive analysis of adherence to treatment and readiness for changes of behavioral risk factors of military personnel with coronary artery disease
Materials and methods. We performed a poll of 72 military personnel (male aged 30–58 years, average age – 47,6±6,5 years) with coronary artery disease, who visited the general practitioners at the Outpatient Care Clinic of the National Military Medical Clinical "Main Military Clinical Hospital". To study the age-related characteristics, patients were divided into two subgroups: up to 50 years (group I – 39 military personnel, mean age 42,8±5,0) and over 50 years (group II – 33 military personnel, mean age 53,2±2,4 years). Based on the results of the study, a computer database was formed. Statistical processing was carried out using Microsoft Excel 2007 and the standard statistical package STATISTICA 6.0.
Results. A low level of medication adherence was found in 84,7% of the military personnel with coronary artery disease (84,6±5,8% in group I and 87,9±5,7% in group II, p=0.70). It should be noted that 79,2% of the surveyed military personnel had a low level of awareness about the need for treatment, 81,9% had a low level of motivation. Insufficient adherence of the surveyed the military personnel with coronary artery disease to the implementation of doctors' recommendations on non-drug treatment was found - most of them rated the implementation of the doctor’s recommendations on three points or less on a five-point scale, including 79,2%, regarding healthy diet and 69,4% regarding physical activity. A high level of smoking prevalence among the military personnel with coronary artery disease was determined – 86,1±2,0% (84,6±5,8% in group I and 87,9±5,7% in group II, p=0,67). At the same time, most of them are at the precontemplation stage about stopping smoking - they were not going to get rid of this habit. There is no statistically significant difference between the military personnel of the I and II groups. It was found that the majority of the military personnel with coronary heart disease are at the contemplation stage to improve physical activity – 29,2% and a healthy diet – 38,9%; only 27,8% and 18,1%, respectively, try to follow the doctor’s recommendations.
Conclusions. A low level of adherence of the military personnel with coronary artery disease to medical and non-medical treatment and insufficient readiness to change behavioral risk factors have been established. The expediency of improving the organization of medical care for the military personnel with coronary artery disease, in particular, the introduction of patient-centered medical care aimed at attracting patients to participate in treatment, increasing motivation and increasing adherence to treatment.
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