scholarly journals Quantitative assessment of adherence to treatment in patients with atrial fibrillation in real clinical practice

2018 ◽  
Vol 90 (1) ◽  
pp. 17-21
Author(s):  
Ju.P. SKIRDENKO ◽  
◽  
N.A. NIKOLAEV ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Quantitative Assessment ◽  
Adherence To Treatment ◽  
Real Clinical Practice

scholarly journals 4CPS-020 Use, efficacy and adherence to treatment with PCKS9 inhibitors in real clinical practice

2020 ◽  
Author(s):  
R Claramunt García ◽  
CL Muñoz Cid ◽  
A Sánchez Ruiz ◽  
AM López ◽  
E Pérez Cano ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Adherence To Treatment ◽  
Real Clinical Practice

scholarly journals Effectiveness of inhaled corticosteroids and long-acting β-agonists combinations in real clinical practice: results of a multicenter cross-sectional study in Russian patients with asthma

2021 ◽  
Vol 31 (5) ◽  
pp. 613-626
Author(s):  
Vladimir V. Arkhipov ◽  
Zaurbek R. Aisanov ◽  
Sergey N. Avdeev
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Asthma Control ◽  
Inhalation Technique ◽  
Adherence To Treatment ◽  
Uncontrolled Asthma ◽  
Cross Sectional ◽  
Long Acting ◽  
Adherence To Therapy ◽  
Real Clinical Practice

Asthma management approaches are improving yearly, but the problem of asthma control is still acute. Combinations of inhaled glucocorticosteroids (ICS) and long-acting β2-agonists (LABA) play a crucial role in asthma therapy, but their effectiveness in real practice can be insufficient, and asthma control level in the population remains low. Optimizing the use of these drugs, changing the usual therapy regimens, and implementing upgraded inhalers can improve adherence to treatment and inhalation technique, which affects the effectiveness of the therapy.The study aimed to describe the key characteristics of the patient population getting asthma treatment in real clinical practice and assess factors influencing asthma control, including adherence to therapy.Methods. A single-stage cross-sectional observational study in 124 primary health care centers in 22 cities of the Russian Federation included 3,214 patients > 18 years old, with a clinical diagnosis of asthma for at least 1 year, who were able to perform a spirometry test and fill out the ACQ-5 and TAI-12 questionnaires.Results. Assessment of asthma control with the ACQ-5 questionnaire showed that most patients had uncontrolled asthma (56%). Controlled and partially controlled asthma was diagnosed in 21 and 19% of patients, respectively. 4% of patients had severe uncontrolled asthma. The TAI questionnaire revealed low adherence to therapy in more than half of the patients (53.6%). The rate of patients with controlled asthma and the average annual frequency of exacerbations were significantly lower in subgroups of patients who received therapy with extrafine ICS/LABA and ICS/formoterol in single inhaler regimen, compared with controller therapy using fixed and free combinations of ICS and LABA.Conclusion. The main causes of insufficient asthma control are low adherence to treatment, inhalation errors, monotherapy with ICS, asthma with small airways dysfunction, and adverse events associated with ICS. Prescribing the combinations of ICS/LABA in the form of extra-fine aerosol and using it in the Maintenance and Reliever Therapy (MART) regimen can significantly increase asthma control, reduce the risk of adverse events, and increase patient adherence to treatment. A potential alternative to improve asthma control is administering ICS-LABA combinations once daily.

scholarly journals Asthma control: actual problems and solutions in real clinical practice

2019 ◽  
Vol 29 (3) ◽  
pp. 346-352
Author(s):  
I. V. Leshchenko
Keyword(s):  
Clinical Practice ◽  
Asthma Control ◽  
Asthma Severity ◽  
Pharmacological Therapy ◽  
Inhalation Technique ◽  
Adherence To Treatment ◽  
Asthma Control Test ◽  
Problems And Solutions ◽  
Long Acting ◽  
Real Clinical Practice

Asthma control is still difficult to achieve. One of main tools for evaluating asthma control is a well-known Asthma Control Test (ACT). Common causes of insufficient asthma control include poor adherence to treatment and non-compliance of the patient with the dosing regimen. Correct inhalation technique significantly contributes to better adherence to treatment. Elliptа is a multi-dose powder inhaler with dose counter and indication of remaining dose number. Actuation of Ellipta inhaler requires only one movement. Inhaled glucocorticosteroids (ICS) and long-acting β2-agonists (LABA) are the key agents in the maintenance pharmacological therapy of asthma. A novel vilanterol/fluticasone furoate (VI/FF) combination is a highly effective combination for maintenance treatment of moderate to severe asthma with 24-hour effect providing once-daily dosing. The Salford study demonstrated advantages of VI/FF combination over ICS monotherapy and other combination of ICS/LABA in real clinical practice in patients with asthma out of dependence of asthma severity or comorbidities.

scholarly journals Atrial fibrillation treatment in Russia: work on bugs

2021 ◽  
Vol 28 (3) ◽  
pp. 1-4
Author(s):  
S. G. Kanorskii
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Russian Federation ◽  
Medical Errors ◽  
Clinical Guidelines ◽  
The Future ◽  
The Russian Federation ◽  
Real Clinical Practice

The article discusses the results of a survey of doctors in the Russian Federation with the aim of studying approaches to the treatment of atrial fibrillation in real clinical practice and comparing the results obtained with the current clinical guidelines. Some new data are presented that could change the recommendations in the future; possible causes of medical errors and ways to correct them are discussed.

Atrial fibrillation in old age: risk management and features of the use of direct oral anticoagulants

Kardiologiia ◽  
2021 ◽  
Vol 61 (6) ◽  
pp. 79-87
Author(s):  
S. G. Kanorskii
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Clinical Situation ◽  
The Russian Federation ◽  
Coronary Events ◽  
Senile Patient ◽  
Reduced Risk ◽  
Real Clinical Practice

Senile patients with atrial fibrillation (AF) are at a higher risk of thromboembolism and hemorrhage than younger patients. Three direct oral anticoagulants (DOAC), apixaban, dabigatran, and rivaroxaban, are registered in the Russian Federation and are extensively used for prevention of stroke in patients with AF. The DOAC treatment of older patients requires considering peculiarities of these patients, clinical situation and properties of individual drugs to achieve the balance of efficiency and safety and a comprehensive protection. According to studies of real clinical practice DOAC may have advantages over warfarin (reduced risk of fractures, diabetes mellitus, and dementia). Compliance with and constancy of the DOAC treatment are important for its efficiency, particularly in senile age. Results of clinical trials and real clinical practice studies have confirmed that rivaroxaban may provide a comprehensive protection for a senile patient with AF due to favorable indexes of efficiency and safety, beneficial effect on the risk of coronary events and impairment оf renal function, whereas once a day dosing of rivaroxaban improves the compliance with this treatment and its constancy.

scholarly journals CRYOABLATION IN ATRIAL FIBRILLATION: RATIONALE OF THE NATIONAL PROSPECTIVE REGISTRY AND PRELIMINARY RESULTS

2018 ◽  
pp. 21-25
Author(s):  
E. N. Mikhailov ◽  
T. A. Lyubimtseva ◽  
K. V. Davtyan ◽  
A. G. Topchian ◽  
E. S. Tarasyuk ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Pulmonary Veins ◽  
National Study ◽  
Cryoballoon Ablation ◽  
Ablation Procedure ◽  
Safety And Efficacy ◽  
Informational System ◽  
Real Clinical Practice

Aim. Current registry is the continued national study on cryoablation in atrial fibrillation (AF). The aim of the project is assessment of safety and efficacy of cryoballoon ablation of pulmonary veins from AF treatment in real clinical practice prospective observation.Material and methods. The project has been developed for prospective inclusion of the data to guarded automatic informational system, on clinical data of patients, ablation parameters, repeat ablation and results of 12-month follow-up. To participate in the project in January of 2017, the representatives of 33 in-patient facilities were invited, that routinely perform the procedure.Results. Twenty five institutions confirmed their participation, and by December of 2017, the database was completed by specialists from 13 clinics: information on the ablation procedure and outcomes is included for 451 patient. The enrollment is ongoing with estimated end by January 2019; prospective follow-up to be completed by January 2020.Conclusion. Prospective registry of AF cryoablation is important for gathering of experience and common analysis of the procedures throughout the country. Detailed analysis will make it to reveal predictors of efficacy and methods for procedural risk decrease.

scholarly journals Rhythm control strategy in patients with atrial fibrillation in real clinical practice

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
V.A. Ionin ◽  
◽  
E.L. Zaslavskaya ◽  
V.A. Pavlova ◽  
E.Yu. Petrischeva, ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Control Strategy ◽  
Rhythm Control ◽  
Real Clinical Practice

scholarly journals Antithrombotic Therapy in Elderly Patients with Atrial Fibrillation: The State of the Problem in the Real Clinical Practice of a Family Medicine Doctor

2021 ◽  
Vol 6 (2) ◽  
pp. 63-69
Author(s):  
Bazira Kanat кyzy ◽  
N. K. Kinderbaeva ◽  
S. O. Turdaliyev ◽  
Zh. A. Mahmudova ◽  
U. K. Kundashev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Family Medicine ◽  
Anticoagulant Therapy ◽  
Antithrombotic Therapy ◽  
Age Groups ◽  
Target Range ◽  
Specialized Team ◽  
Real Clinical Practice

Introduction. The research aimed at studying the efficacy and safety of anticoagulant therapy in patients with atrial fibrillation (AF), especially in older age groups, is now increasingly relevant.The aim of the study is to analyze the situation with prescribing anticoagulant therapy in elderly and senile persons with atrial fibrillation in real clinical practice and to demonstrate the possibility of improving the quality of observation and management of a group of patients as part of the work of a specialized team.Materials and methods. A total of 2,770 medical records of outpatient patients with atrial fibrillation were studied for the period from 2017 to 2019. Of this number, 320 patients with AF of nonvalvular etiology were selected, the average age of which was 70.3 ± 8.15 years. There were 270 women and 50 men. An observational prospective study in 45 elderly and senile patients with AF of non-valvular etiology was carried out by a team of specialized doctors for 12 months.Results. Of the 301 patients, anticoagulant therapy was prescribed to 166 (55.1 %), of which only 17 (10.2 %) people received proper anticoagulant therapy. The excessive activity was observed in 114 (37.9 %) patients, who underwent antiplatelet therapy with aspirin, and 21 (7.0 %) patients remained without any treatment with anticoagulants nor antiplatelet agents. Although, in the case of both, prescribing aspirin and not prescribing, anticoagulants have been indicated. In the prospective part of the study (for 12 months), all 45 patients continued to take anticoagulants and were systematically monitored. The INR in the target range over 60 % of the time was achieved in 37 % of patients receiving warfarin therapy.Conclusion. In the actual clinical practice of Kyrgyzstan family medicine centers, older patients with atrial fibrillation receive inadequate antithrombotic therapy. The main drug of choice for specialists remains warfarin, a therapy that can be recognized as adequate only in a small number (16 %) of patients. The ability to improve the quality of surveillance and management of a group of patients with AF and high adherence to treatment was demonstrated by the work of a specialized team of doctors. 

scholarly journals Possibilities of Using Rivaroxaban in Elderly Patients with Atrial Fibrillation: Data from Randomized Studies and Real Clinical Practice

2018 ◽  
Vol 14 (4) ◽  
pp. 575-582
Author(s):  
N. M. Vorobyeva ◽  
O. N. Kacheva
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Age Groups ◽  
Minor Bleeding ◽  
Systemic Embolism ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Real Clinical Practice

The possibility of rivaroxaban using in elderly patients with non-valvular atrial fibrillation is discussed in the review. The results of ROCKET-AF randomized trial, including subgroup analysis in patients older than 75 years, are presented. The problem of unreasonable prescription of low doses of anticoagulants in real clinical practice and questions of adherence of patients to anticoagulant therapy are discussed. The results of two recent studies of actual clinical practice performed in patients over the age of 80 and 85 years, respectively, are presented as well as favorable profile of the efficacy and safety of rivaroxaban in these age groups. Rivaroxaban reduced the risk of stroke/systemic embolism by 38% and ischemic stroke by 41% with a comparable risk of major bleeding in patients older than 80 years. In another study, in patients older than 85 years in the rivaroxaban group, a 11% reduction in the risk of death from all causes, a reduction in the risk of major bleeding by 10% and an acute coronary syndrome by 14%, with similar risk of stroke/systemic embolism, clinically significant minor bleeding and a combined endpoint (stroke/systemic embolism, large bleeding, death from all causes) have been found.

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