TREATMENT COMPLIANCE AMONG PATIENTS WITH CHRONIC PANCREATITIS IN THE MOSCOW REGION

Cover Page


Cite item

Full Text

Abstract

Background: In the past decade, incidence of chronic pancreatitis among different age groups has been growing globally and in Russia. Chronic pancreatitis is a progressive disease characterized by development of complications and decrease of exocrine function of pancreas. Treatment should be initiated early, before the complications occur; therapy should account for international experience and established Russian guidelines. Continuous usage of high-dose enzyme preparations preferably in modern dosage forms (microgranules, minimicrospheres or microtablets) is one of the key principles in the management of chronic pancreatitis. Patient’s cooperative behavior and good compliance is crucial for achieving treatment targets. Aim: To assess treatment compliance among patients with chronic pancreatitis in the Moscow Region and to identify sources of information on the disease used by the patients. Materials and methods: One hundred patients with chronic pancreatitis in Moscow Region were questionnaired anonymously on their adherence to the medical recommendations for diet, alcohol consumption and medications, particularly enzyme preparations. Patients’ sources of information on the disease were also determined. Results: Poor compliance results were shown: only 28% of patients were fully adherent to medical recommendations; other patients took their medications irregularly, changed drug doses or preparations choosing less expensive and effective drugs. The majority of patients (89%) were aware of the main treatment principles, though, 53% didn’t adhere to them. Patients used varied sources of information on the disease including special literature and the web; nevertheless, the information could be incorrectly understood. Only some patients received disease-related information from their physician, and many of the patients described physician-derived information as insufficient. As a result, treatment was often inadequate. Conclusion:  Improved patients’ compliance is a crucial factor in achieving treatment targets in chronic pancreatitis. Two-way interventions are needed: 1. training of physicians in the disease field and in presenting clear and correct information to patients. 2. multimodal patients’ education.

About the authors

S. V. Beljakova

Orekhovo-Zuevo Central City Hospital; 13 Baryshnikova ul., Orekhovo-Zuevo, Moscow Region, 142611,
Russian Federation

Author for correspondence.
Email: sve79@yandex.ru
physician-gastroenterologist, Orekhovo-Zuevo Central City Hospital Russian Federation

E. A. Belousova

Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: fake@neicon.ru

MD, PhD, Professor, Head of the Department of Gastroenterology and Hepatology, Head of the Chair of Gastroenterology, the Faculty of Postgraduate Medical Education, MONIKI; Principal Gastroenterologist of the Moscow Region

Russian Federation

References

  1. Маев ИВ, Вьючнова ЕС, Дичева ДТ, Овсянникова ЕВ. Эффективность ингибитора протонной помпы омепразола (лосека МАПС) при хроническом панкреатите в стадии обострения. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2001;11(6):54-7. (Maev IV, V’yuchnova ES, Dicheva DT, Ovsyannikova EV. [Efficacy of proton pump inhibitor – omeprazole (Losec MUPS) in relapse of chronic pancreatitis]. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 2001;11(6):54-7. Russian).
  2. Маев ИВ, Казюлин АН, Кучерявый ЮА, Демочко ЕА, Пирогова АИ. Некоторые вопросы эпидемиологии хронического панкреатита. В: Цуканов ВВ, ред. Клинико- эпидемиологические и этно-экологические проблемы заболеваний органов пищеварения. Материалы Третьей Восточно-Сибирской гастроэнтерологической конференции. Красноярск; 2003. с. 49-52. (Maev IV, Kazjulin AN, Kucheryavyy JuA, Demochko EA, Pirogova AI. Some epidemiological aspects of chronic pancreatitis. In: Tsukanov VV, editor. Clinical epidemiological and ethno-ecological aspects of digestive organs diseases. Materials of the 3rd East-Siberian Gastroenterology Conference. Krasnoyarsk; 2003. p. 49-52. Russian).
  3. Mitchell RM, Byrne MF, Baillie J. Pancreatitis. Lancet. 2003;361(9367):1447-55.
  4. Маев ИВ, Казюлин АН, Кучерявый ЮА. Хронический панкреатит. М.: Медицина; 2005. (Maev IV, Kazyulin AN, Kucheryavyy YuA. Chronic pancreatitis. Moscow: Meditsina; 2005. Russian).
  5. Калинин АВ, Логинов АФ, Хазанов АИ, ред. Гастроэнтерология и гепатология: диагностика и лечение. Руководство для врачей. М.: МЕДпресс-информ; 2013. (Kalinin AV, Loginov AF, Khazanov AI, editors. Gastroenterology and hepatology: diagnosis and treatment. Manual for physicians. Moscow: MEDpress-inform; 2013. Russian).
  6. Waljee AK, Dimagno MJ, Wu BU, Schoenfeld PS, Conwell DL. Systematic review: pancreatic enzyme treatment of malabsorption associated with chronic pancreatitis. Aliment Pharmacol Ther. 2009;29(3):235-46.
  7. Тучина ЛМ, Порошенко ГГ. Распространенность заболеваний поджелудочной железы среди населения г. Москвы. Российский гастроэнтерологический журнал. 2001;(2):154. (Tuchina LM, Poroshenko GG. [Predominance of the diseases of pancreas in population of Moscow]. Rossiyskiy gastroenterologicheskiy zhurnal. 2001;(2):154. Russian).
  8. Губергриц НБ. Лечение панкреатитов. Ферментные препараты в гастроэнтерологии. М.: Медпрактика-М; 2003. (GubergritsNB. Treatment of a pancreatitis. Pancreatic enzyme preparations in gastroenterology. Moscow: Medpraktika-M; 2003. Russian).
  9. Bornman PC, Botha JF, Ramos JM, Smith MD, Van der Merwe S, Watermeyer GA, Ziady CC. Guideline for the diagnosis and treatment of chronic pancreatitis. S Afr Med J. 2010;100(12 Pt 2): 845-60.
  10. Haaber AB, Rosenfalck AM, Hansen B, Hilsted J, Larsen S. Bone mineral metabolism, bone mineral density, and body composition in patients with chronic pancreatitis and pancreatic exocrine insufficiency. Int J Pancreatol. 2000;27(1):21-7.
  11. Белоусова ЕА, Никитина НВ, Цодиков ГВ. Оптимизация схем лечения хронического панкреатита ферментными препаратами. Фарматека. 2008;(13):103-8. (Belousova EA, Nikitina NV, Tsodikov GV. [Pancreatic enzyme preparations improve the treatment algorithm for chronic pancreatitis]. Farmateka. 2008;(13):103-8. Russian).
  12. Krishnamurty DM, Rabiee A, Jagannath SB, Andersen DK. Delayed release pancrelipase for treatment of pancreatic exocrine insufficiency associated with chronic pancreatitis. Ther Clin Risk Manag. 2009;5(3):507-20.
  13. Ивашкин ВТ, Маев ИВ, Охлобыстин АВ, Кучерявый ЮА, Трухманов АС, Шептулин АА, Шифрин ОС, Лапина ТЛ, Осипенко МФ, Симаненков ВИ, Хлынов ИБ, Алексеенко СА, Алексеева ОП, Чикунова МВ. Протокол диагностики и лечения хронического панкреатита. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2014;24(4):70- 97. (Ivashkin VT, Maev IV, Okhlobystin AV, Kucheryavyy YuA, Trukhmanov AS, Sheptulin AA, Shifrin OS, Lapina TL, Osipenko MF, Simanenkov VI, Khlynov IB, Alekseenko SA, Alekseeva OP, Chikunova MV. [Protocol diagnostics and treatment of chronic pancreatitis]. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 2014;24(4):70-97. Russian).
  14. Frulloni L, Falconi M, Gabbrielli A, Gaia E, Graziani R, Pezzilli R, Uomo G, Andriulli A, Balzano G, Benini L, Calculli L, Campra D, Capurso G, Cavestro GM, De Angelis C, Ghezzo L, Manfredi R, Malesci A, Mariani A, Mutignani M, Ventrucci M, Zamboni G, Amodio A, Vantini I; Italian Association for the Study of the Pancreas (AISP), Bassi C, Delle Fave G, Frulloni L, Vantini I; Zamboni G. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis. 2010;42 Suppl 6:S381-406.
  15. Layer P, Keller J, Lankisch PG. Pancreatic enzyme replacement therapy. Curr Gastroenterol Rep. 2001;3(2):101-8.
  16. Белоусов ЮБ, Кукес ВГ, Лепахин ВК, Петров ВИ, ред. Клиническая фармакология: национальное руководство. М.: ГЭОТАР-Медиа; 2014. (Belousov YuB, Kukes VG, Lepakhin VK, Petrov VI, editors. Clinical pharmacology: national guidelines. Moscow: GEOTAR-Media; 2014. Russian).
  17. Бутов ЮС, Скрипкин ЮК, Иванов ОЛ, ред. Дерматовенерология: национальное руководство. М.: ГЭОТАР- Медиа; 2013. (Butov YuS, Skripkin YuK, Ivanov OL, editors. Dermatovenerology: national guidelines. Moscow: GEOTARMedia; 2013. Russian).
  18. Кобалава ЖД, Котовская ЮВ, Моисеев ВС. Артериальная гипертония. Ключи к диагностике и лечению: руководство. М.: ГЭОТАР-Медиа; 2009. (Kobalava ZhD, Kotovskaya YuV, Moiseev VS. Arterial hypertension: keys to diagnosis and treatment. Moscow: GEOTAR-Media; 2009. Russian).
  19. Чучалин АГ, ред. Пульмонология: национальное руководство. М.: ГЭОТАР-Медиа; 2009. (Chuchalin AG, editor. Pulmonology: national guidelines. Moscow: GEOTAR-Media; 2009. Russian).

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Beljakova S.V., Belousova E.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies