Treatment Assessment Among Hypertensive Patients of a Rural Polyclinic in Russia: The Results of Structured Questionnaire

Abstract

Information on treatment obtained from hypertensive patients could add the data of medical records and reveal the problems addressed to hypertensives’ attitudes and behavior. To evaluate patients’ knowledge on hypertension and treatment behavior at a rural polyclinic with the help of structured questionnaire. We interviewed 83 patients with essential hypertension (64.6±9.6 yo; 30% - men) who referred to a polyclinic of a rural settlement in the Saratov region of the Russia. Consecutive patients with hypertension diagnosis specified in their medical records, visiting a therapeutist or cardiologist on one randomly selected workday, were enrolled in our study. The appointment took place during 1-31 July 2015. Eleven district therapeutists, two general practitioners and the only cardiologist of the polyclinic participated in the study. Structured questionnaire for patients with elevated Blood Pressure (BP) proposed by S.N. Gerasimov et al. (2015) was used for interviewing. The questionnaire included 16 questions addressed to the following issues: Awareness of hypertension and risk factors, BP self-monitoring, non-pharmacological and pharmacological treatment, adherence to antihypertensive therapy, referrals to medical care. Ninety percent of respondents have known previously about BP elevation. Ninety four percent of patients had a tonometer at home. Eighty four percent of hypertensives measured their BP no rare than once a week, and fifty four percent did it every day. Eighty eight percent of study participants took antihypertensive drugs regularly. Only 36% of patients could be classified as adherent to therapy according to the Morisky-Green scale. Ninety two percent of respondents received one or more advices on lifestyle modification. Eighty two percent underwent diet counseling. Two-third of participants were advised to reduce their weight. About half of hypertensives were asked by the doctor to increase their physical activity. One-third of patients received smoking cessation advice, and the same part of enrollees received advice on alcohol consumption. The majority of patients (62.7%) were interested in organization of special follow-up program. With the help of structured questionnaire we revealed high frequency of BP self-measurement among visitors of rural polyclinic in Saratov region whereas the adherence to antihypertensive medication was low. We observed good level of knowledge on non-pharmacologic treatment interventions and revealed patients’ interest in special follow-up program. Such program should be addressed to the increase of patients’ adherence to treatment.