Compliance monitoring in patients with fatty hepatosis at a rural therapeutic site
https://doi.org/10.52485/19986173_2021_1_22
Abstract
The aim of the research. To monitor compliance in patients with fatty hepatosis of various etiologies.
Materials and methods. 1152 people out of 1568 residents of the rural therapeutic site agreed to participate in the study. The survey included: subjective data, including alcohol history, physical examination. The biochemical parameters of blood were studied: alanine aminotransferase, aspartate aminotransferase, total protein, albumin, prothrombin index. An ultrasound examination of the abdominal organs was performed. Adherence to therapy was assessed 6 months after treatment and lifestyle counseling.
Results. Fatty hepatosis within the framework of alcoholic liver disease (ALD) was in 167 (14.5%) people, within the framework of non-alcoholic fatty liver disease (NAFLD) - in 225 (19.5%) (p>0.05). There were 43 smokers among patients with liver steatosis with NAFLD (19.1%), while those with ALD - 145 people (86.8%) (p <0.001). Among patients with fatty hepatosis with ALD, medical recommendations were followed in 11 (6.6%), with NAFLD - 45 (20.0%) (p<0.05). There were no gender differences among them (p> 0.05). Of 124 patients with alcoholic fatty hepatosis at the age of 18-59 years, 11 (8.9%) people followed the recommendations, out of 43 patients 60 years and older - none (p> 0.05), while of 108 patients with non-alcoholic steatosis - 29 (26.9%) and 16 (13.7%) (p <0.05), respectively.
Conclusion. Compliance was better in patients with non-alcoholic fatty hepatosis (20.0%), than alcoholic (6.6%) (p <0.05). Gender differences did not affect compliance (p> 0.05). Among patients with non-alcoholic hepatosis, compliance was more pronounced in people of working age (p <0.05). Among patients with liver steatosis with ALD, there were 86.8% smokers, with NAFLD - 19.1% (p <0.001). Smoking is an additional risk factor for the development of ALD. At the first contact with a doctor, only 13% of patients with alcoholic fatty hepatosis admit to alcohol abuse.
About the Authors
N. V. MikhailovaRussian Federation
4 Kuibysheva str., Usolye-sibirskoye, 665459
I. l. Petrunko
Russian Federation
100 Yubileyniy, Irkutsk, 664049
References
1. Dorofeeva A. E., Rudenko N. N. Non-Alcoholic fatty liver disease: modern approaches to diagnosis and treatment.Gastroenterology. 2015. 527. 17-20. in Russian.
2. Adherence to long-term therapies: evidence for action. Geneva. WHO. 2003. Accessed May 15, 2020 https://www.who.int/chp/knowledge/publications/adherence_report/en/
3. Makhov V.M., Volodina Т.V., Panferov A.S. Fatty liver disease. Modern pathogenetic approach to therapy. Medical Council. 2016. 9. 76-82. doi.org/10.21518/2079-701X-2016-9-76-82. in Russian.
4. Ivashkin V.T., Drapkina O.M., MayevI.In. et al. Prevalence of non-alcoholic fatty liver disease in outpatient practice patients in the Russian Federation: results of the DIREG 2.Russian journal of gastroenterology, Hepatology, and Coloproctology. 2015. 6. 31-41. in Russian.
5. Menon K.V., Gores G.J., Shah V.H. Pathogenesis, diagnosis, and treatment of alcoholic liver disease. Mayo Clin Proc. 2001. 76(10). 1021-1029.
6. Ivashkin V.T., Mayevskaya M.V., Pavlov Ch.S. et al. Management of adult patients with alcoholic liver disease: clinical guidelines of the Russian Scientific Liver Society.Russian journal of gastroenterology, Hepatology, and Coloproctology. 2017. 27(6). in Russian.
7. Vertkin A.L., Komarovsky A.N., Skotnikov A.S. Alcohol-associated conditions in a multidisciplinary hospital.Attending physician. 2011. 11(11). Accessed 17.04.2020. https://www.lvrach.ru/2011/09/10433432/ in Russian.
8. Ivashkin V.T., Mayevskaya M.V., Pavlov CH.S. et al. Clinical recommendations for the diagnosis and treatment of non-alcoholic fatty liver disease of the Russian society for the study of the liver and the Russian gastroenterological Association. Russian journal of gastroenterology, Hepatology, and Coloproctology. 2016. 26(2). 24-42. in Russian.
9. Corrao G., Lepore A.R., Torchio P. et al. The effect of drinking coffee and smoking cigarettes on the risk of cirrhosis associated with alcohol consumption. A case-control study. Provincial Group for the Study of Chronic Liver Disease.Eur J Epidemiol. 1994. 10 (6). 657-664.
10. Vostrikov V.V., Zelentsov K.E., Maiorova O.V. et al. Methods of Diagnostics of Alcoholism. Reviews of clinical pharmacology and drug therapy. 2008. 6(4). 26-52. in Russian.
11. Mayevskaya M.V., Bakulin I.G., Chirkov A.A. et al. Alcohol abuse in gastroenterological patients. Russian journal of gastroenterology, Hepatology, and Coloproctology. 2016. 26(4). 24- 35. in Russian.
12. The world health organization. The European Information System. Accessed 15.05.2020 http://www.euro.who.int/ru/health-topics/disease-prevention/alcohol-use/data-and-statistics.
13. Vertkin A.L., Zayratyants O.V., Vovk E.I. Final diagnosis. GEOTAR-Media. 2008. in Russian.
14. Alcoholic liver disease. National Guidelines. Approved by the scientific society of gastroenterologists of Russia, the Russian scientific medical society of therapists. 2019. Accessed 16.05.2020. https://www.rnmot.ru/public/uploads/RNMOT/clinical/2019/
15. Fomina N.V., Fomin I.V., Fedoseeva T.E. Relation of doctors and patients to treatment of the illness as social and psychological problem (on the example of treatment of an arterial hypertension). Bulletin of Minin University. 2016. 2(15). 28. in Russian.
16. Nedogoda S.V., Tsoma V.V., ledyaeva A.A. Adherence to statin therapy and the possibility of its improvement in real clinical practice. RMJ. 2009. 8. 1086 Accessed 16.05.2020. https://www.rmj.ru/articles/kardiologiya/Priverghennosty_k_terapii_statinami. in Russian.
17. Cramer J.A., Amonkar M.M., Hebborn A., Altman R. Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin. 2005.21(9). 1453-1460.
18. Osterberg L., Blaschke T. Adherence to medication. N Engl J Med. 2005. 353(5). 487-497.
19. Kim M.T., Han H.R., Hill M.N., et al. Depression, substanceuse, adherence behaviors, and blood pressure in urban hypertensive blackmen. Ann Behav Med. 2003.26(1). 24-31.
20. Jin J., Sklar G.E., Oh VMS, et al. Factors affecting therapeutic compliance: A rewiew from the patient`s perspective. TherClin Risk Manag. 2008. 4(1). 269-286.
Review
For citations:
Mikhailova N.V., Petrunko I.l. Compliance monitoring in patients with fatty hepatosis at a rural therapeutic site. Transbaikalian Medical Bulletin. 2021;(1):22-31. (In Russ.) https://doi.org/10.52485/19986173_2021_1_22