systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»systhiper-381Research ArticleКАРДИОЛОГИЯCARDIOLOGYИзменения в лечении артериальной гипертензии в Ярославской области: промежуточные результаты годовой реализации комплексной программы по модернизации областной системы здравоохраненияModernization of hypertension treatment in the Yaroslavl region: interim results of the yearly comprehensive program for modernization of the regional healthcare systemМожейкоМ. Е.MozheykoM. E.mmozheiko@yandex.ruЕрегинС. Я.EreginS. Y.noemail@neicon.ruВигдорчикА. В.VigdorchikA. V.noemail@neicon.ruКлимовскаяИ. М.KlimovskaiaI. M.noemail@neicon.ruРиахиФ.RiahiF. ..noemail@neicon.ruХьюзД.HughesD. ..noemail@neicon.ruГБУЗ ЯО Ярославский областной клинический госпиталь ветеранов войнRussian FederationКардиологический центр ГБУЗ Ярославская областная клиническая больницаRussian FederationООО «Новартис Фарма», МоскваRussian Federation«Новартис АГ», Базель, ШвейцарияRussian Federation2014231220221143036Copyright © Можейко М.Е., Ерегин С.Я., Вигдорчик А.В., Климовская И.М., Риахи Ф..., Хьюз Д..., 20222022Можейко М.Е., Ерегин С.Я., Вигдорчик А.В., Климовская И.М., Риахи Ф., Хьюз Д.Mozheyko M.E., Eregin S.Y., Vigdorchik A.V., Klimovskaia I.M., Riahi F..., Hughes D...Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/381

Цель исследования. В настоящей работе сравнивались конечные точки двух одномоментных исследований, оценивавших артериальное давление (АД) у пациентов до и после внедрения нового протокола терапии артериальной гипертензии (АГ) в государственных амбулаторных учреждениях Ярославской области Российской Федерации. Работа проводилась в рамках комплексной программы Департамента здравоохранения и фармации Ярославской области по усовершенствованию лечения АГ. Материалы и методы. Программа Департамента здравоохранения и фармации Ярославской области включала в себя: приоритезацию диагностики и лечения АГ, создание управляющего комитета для координации деятельности и оценки эффективности программы; внедрение унифицированных протоколов и стандартов диагностики и лечения АГ посредством интенсивных образовательных программ; проведение общественно-образовательной кампании, направленной на вовлечение и обучение населения соблюдать терапию АГ. Два одномоментных дневниковых исследования (одно из них проводилось до, другое - через 13 мес после начала программы) были проведены для оценки прогресса программы по АГ. Исследования оценивали контроль уровня АД в качестве первичных измерений и средние уровни АД и его распределение, факторы риска развития сердечно-сосудистых заболеваний и сопутствующих заболеваний, частоту сердечных сокращений и гипотензивную терапию в качестве вторичных измерений.Результаты. Исследования были проведены в 2011 (базовый уровень) и 2012 г. (1794 и 2992 дневника пациента соответственно) в 38 областных лечебно-профилактических учреждениях. Контроль уровня АД (<140/90 мм рт. ст.) значительно вырос по сравнению с базовым уровнем (с 16,8 до 23,0%), отражая относительное улучшение на 37% (р<0,0001). Средний уровень АД значительно снизился (с151/90 до 147/88 мм рт. ст., р<0,0001). Частота неконтролируемой АГ тяжелой степени (систолическое АД≥180 ммрт. ст.) снизилась с 9,7 до 6,4% (р<0,0001).Заключение. Программа модернизации диагностики и лечения АГ, основанная на национальных рекомендациях и образовательных программах для специалистов здравоохранения и пациентов, привела к внедрению более эффективных подходов к терапии АГ и улучшению контроля АД у пациентов.

Goalofthestudy. This project comparedblood pressure (BP)-related endpointsin two cross-sectional surveys of hypertensive patients visiting public outpatient healthcare facilities in the Yaroslavl Region of Russia before and after initiation of a comprehensive healthcare system modernization program for hypertension leaded by Department of Health and Pharmacy of Yaroslavl Region.Materials and methods. Hypertension treatment modernization program included making hypertension diagnostics and treatment a priority by setting up a Steering Committee to coordinateand evaluatethe program progression; introduction of hypertension diagnostics and treatment protocol and standards region-wide via an intensive educational program for healthcare professionals; conduction of public education campaign increasingcommunity engagement and hypertension therapyadherence. Two cross-sectional surveys, one at baseline and the other13 monthsafterprograminitiation, were conducted to monitor the evolution of hypertension management. Surveys evaluated BP control rate as a primary measure and mean BP levels and distribution, cardiovascular risk factors, and associated conditions, heart rate levels, and antihypertensive therapy as a secondary measures.Results. Surveys were conducted in 2011 (baseline) and 2012 (1,794 and 2,992 patients respectively) across 38 Regional clinics. BP control levels (<140/90) improved significantly over baseline (16,8% vs 23,0%) reflecting a 37% relative improvement (p<0,0001), as did mean BP (from 151/90 to 147/88; р<0,0001) and the proportion of patients with severe uncontrolled hypertension (systolic BP≥180 mm Hg) was reduced from 9,7% to 6,4% (p<0,0001).Conclusions. Implementing a guidelines-based comprehensive health systems improvement programvia medical and patient education programs resulted in introduction of more optimal therapy approaches and improved patient BP control across Yaroslavl region.

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The authors declare that there are no conflicts of interest present.