ОЦЕНКА КОМПЛАЕНСА ПРИ РАЗЛИЧНЫХ ФОРМАХ ОСТРОГО ИНФАРКТА МИОКАРДА (по данным регистра

Purpose: Assessment of the level of compliance (adherence) of patients with various forms of acute myocardial infarction (AMI) to medical recommendations; establishing the reasons for non-compliance (according to the register of AMI). Material and methods: 82 respondents with a diagnosis of AMI were examined. The study of patient compliance was determined by a special Moriski-Green questionnaire, which included general questions (gender, age, duration of illness) and questions aimed at determining the level of patient compliance. Causal factors were also studied on the basis of which patients with AMI did not take therapy. Two groups were identified depending on the form of AMI: 1g. - 58 patients with a diagnosis of AMI with Q and 2g. - 24 patients with a diagnosis of AMI without Q. Results: A comparative analysis of patient compliance depending on the form of AMI revealed that the average score on the Moriski-Green scale on 0.21 units was higher in individuals of 2g. than in patients of the comparison group. Moreover, in both groups not a single patient was completely adherent to therapy. The number of people who scored < 3 points on a scale was 8.1 % higher in group 1, however, the differences identified did not reach the level of confidence. In case of single-vessel lesions, the average level of patient adherence was 1.70 points, which was 0.17 points higher than for two-vessel lesions and 0.19 points lower than for multivascular lesions (all p> 0.05), which was explained by us firstly, the small number of patients and secondly, the percentage of patients who had a history of AMI, similar to patients with single-vascular lesions. An analysis of the reasons for patient non-compliance showed that about 50 % of the respondents cited as the cause of non-compliance - forgetfulness or inattention; 15.8 % - feeling good, i.e. these patients took therapy only when they became ill; 3.7 % - “Internet therapy”, i.e. these patients, relying on information from social networks and, sometimes, misinterpreting it, arbitrarily canceled medical recommendations. Conclusion: At the initial stage, 89.0 % of the examined were less or not committed to therapy, while patients with AMI with Q were less compliant than patients with AMI without Q. The level of compliance was inversely correlated with the number of affected coronary vessels and the length of the atherosclerotic lesion . In addition, the lower the compliance among patients, the higher the likelihood of developing a more severe form of myocardial infarction (AMI with Q), all p> 0.05. The main causes of non-compliance were - forgetfulness / inattention of patients to the prescribed therapy. Electronic access to social networks contributed to the development of the syndrome of “Internet therapy” - in 3.7 % of cases, which also reduced the level of patient compliance.