Медико-организационные проблемы информирования населения о факторах риска болезней системы кровообращения

Abstract

During last 20 years in the structure ot causes of mortality of Ukrainian population cardiovascular diseases are leading and mortality from them in 2013 made up 65,7%. Preventive direction - is the formation of healthy way of living, from which individual health depends more than 50%, and struggle with risk factors. The aim of our work was analysis of awareness of population of cardiovascular diseases risk factors with accounting of health care organization staff resources. To achieve our goal we analyzed staff potential of physicians-of therapeutic profile, who participate in awareness of population of cardiovascular diseases risk factors: therapeutists (all together), district therapeutists, family physicians, cardiologists, neurologists. During 2005-2012 y. provision of these physicians to population of Zaporozhye region is constant, their fluctuations during this period are within the statistical error. 83,33+7,61% among surveyed physicians state, that they talk about the lifestyle and its correction with patient only when they have time.-There is significant difference between physicians of primary medical-sanitarian health care and physicians-specialists of therapeutic profilewho always talk to patients about lifestyle: 44,44+16,56% и 100%, accordingly, (p<0,05). Only 54,17+10,17% among surveyed physicians regardless of the profile pay attention to talk about risk factors, because of this 62,9+9,88% of patients, according to physicians' opinion, do not completely understand their influence on health, this conflicts with patients’ opinion, according to interview 80,68+4,21 % of them are sure, that physician had a conversation about prevention of cardiovascular diseases, a 72,72+4,75% even follow the doctor's recommendations. We established the leading causes, according to which working age population, do not take or take irregularly antihypertensive drugs: lack of money and fear before side effects of treatment are equal: 33,33+13,61 %, so 25,0+12,5% choose alternative ways of treatment. As result of all above listed 50,0+8,57% patients noted hypertensive crises once (52,94+12,11%) or twice (41,18+11,94%) a year, and only 3,57+3,51 % associate them with irregular taking of antihypertensive drugs. According to surveyed physicians’ data, after adoption of pilot project for the treatment of patients with essential hypertension, all patients are provided with preferential prescriptions and informed. This is contrary to the survey of patients according to which only 50,0+5,33% take this preferences, and leading reasons of not using it are lack of information about this- 22,73+4,47; or physician did not propose preferential prescription - 13,64+3,66%; do not believe in program - 7,95+2,88%, that makes all together almost 45% of those, who did not use preferential prescriptions because of lack of information and 4,55+2,22% more couldn’t receive them in the drugstore. We proved, that one of the leading reasons in ineffective struggle again cardiovascular diseases risk factors in Ukraine is lack of informative-educational model of healthy lifestyle instruction of population at all levels of health care provision. This problem can be solved only at state level with attraction of society.

На протяжении последних 20 лет в структуре причин смертности населения Украины лидируют болезни системы кровообращения, удельный вес которых в 201 Зг. составил 65,7%. Нами установлены ведущие причины не регулярного лечения артериальной гипертензии населением трудоспособного возраста: отсутствие денежных средств и страх перед побочным действием препарата в равных долях - по 33,33+13,61%, поэтому 25,0+12,5% лечатся альтернативными методами. В результате у 50,0+8,57% отмечаются гипертонические кризы один (52,94+12,11%) или два (41,18+11,94%) раза в год, которые только 3,57+3,51 % связывают с нерегулярным приемом антигипертензивных препаратов. Доказано, что одной из ведущих причин неэффективной борьбы с факторами риска болезней системы кровообращения в Украине есть отсутствие информационно-просветительской модели обучения населения здорового образу жизни на всех уровнях оказания медицинской помощи. Подтверждением этого является факт, что пользуется льготным медикаментозным обеспечением 50,0+5,33% пациентов, а ведущими причинами их не использования есть отсутствие информации о льготах - 22,73+4,47; врач не предложил пациенту льготный рецепт - 13,64+3,66%; не верят в программу — 7,95+2,88%. Решить эту задачу возможно только на государственном уровне с привлечением общественности.