Приверженность пациентов лечению хронических заболеваний в особых социальных условиях: обзор зарубежных исследований в период пандемии COVID-19

Актуальность. Пандемия COVID-19 повлияла как на экономику в целом, так и на организацию медицинской помощи, на условия функционирования и  состояние большинства пациентов с хроническими заболеваниями, требующими систематического соблюдения врачебных рекомендаций. Введенные ограничения и самоизоляция привнесли сложности в терапию заболеваний, соблюдение режима лечения и контроль показателей здоровья. Отмечаемые у пациентов стресс, депрессивные переживания и снижение социальной поддержки могли существенно снизить приверженность терапии хронических заболеваний во время пандемии; это связано с повышенным риском обострения заболеваний и летальных исходов у пациентов, что и обусловливает актуальность изучаемой темы.

Целью настоящего обзора было рассмотрение проблемы приверженности пациентов лечению хронических заболеваний в период пандемии COVID-19, в том числе специфических для разных нозологических групп последствий и паттернов поведения, касающихся приверженности лечению, являющейся объектом данного исследования.

Методология. Был проведен аналитический обзор результатов исследований в  области изучаемой проблемы; материалом исследования послужили 50 научных статьях, опубликованных преимущественно в 2020–2023 гг. и индексированных в международных базах данных.

Результаты. Отмечается, что, несмотря на некоторые противоречия в  полученных различными авторами эмпирических данных, касающихся повышения/снижения уровня приверженности лечению, исследователи сходятся во мнении, что лица, страдающие хроническими заболеваниями, во время пандемии COVID-19 испытывали на себе сочетанное действие целого ряда негативных факторов в  контексте труднодоступности медицинской помощи, малоподвижного образа жизни и повышенного стресса и тревоги. В ряде случаев указанные факторы приводили к повышению уязвимости в отношении факторов риска хронических заболеваний, а также факторов риска тяжелого течения коронавируса.

Опыт, полученный пациентами во время пандемии, позволяет сделать выводы, касающиеся необходимости своевременной диагностики эмоциональных нарушений, а  также использования информирования с  целью повышения приверженности лечению. Базовые интервенции могут касаться использования инновационных цифровых решений в области здравоохранения, обучения / тренингов по самоконтролю для пациентов.

Заключение. Описанные результаты и выводы представляют интерес в долгосрочной перспективе, поскольку позволяют формулировать цели и задачи для оптимизации организации помощи пациентам в ситуациях, подобных пандемии COVID-19, которые могут ожидать человечество в будущем. 

1. Alharbi R., Qadri A., Mahnashi M. [et al.]. Utilization of Health Applications among Patients Diagnosed with Chronic Diseases in Jazan, Saudi Arabia during the COVID-19 Pandemic // Patient preference and adherence. 2021. Vol. 15. Pp. 2063–2070. DOI: 10.2147/PPA.S329891

2. Alkhotani A., Siddiqui M.I., Almuntashri F., Baothman R. the effect of COVID-19 pandemic on seizure control and self-reported stress on patient with epilepsy // Epilepsy & Behavior. 2020. Vol. 112. Pp. 107323. DOI: 10.1016/j.yebeh.2020.107323

3. Asheq A., Ashames A., Al-Tabakha M. [et al.]. Medication adherence in type 2 diabetes mellitus patients during Covid-19 pandemic: a cross-sectional study from the United Arab Emirates // F1000Research. 2021. Vol. 10. Pp. 435. DOI: 10.12688/f1000research.51729.2

4. Assenza G., Lanzone J., Brigo F. [et al.]. Epilepsy care in the time of COVID-19 pandemic in Italy: risk factors for seizure worsening // Frontiers in neurology. 2020. Vol. 11. Pp. 737. DOI: 10.3389/fneur.2020.00737

5. Bandyopadhyay S., Maji B., Mitra K. A Study on Adherence to Medicines and Lifestyle of Diabetic Patients Attending a Tertiary Care Hospital in Kolkata Post-coronavirus Disease Lockdown // Annals of Community Health. 2021. Vol. 9, N 2. Pp. 91–94.

6. Baranova A., Cao H., Zhang F. Causal associations and shared genetics between hypertension and COVID-19 // Journal of Medical Virology. 2023. Vol. 95. Pp. e28698. DOI: 10.1002/jmv.28698

7. Barron E., Bakhai C., Kar P. [et al.]. Associations of Type 1 and Type 2 Diabetes with COVID-19-Related Mortality in England: A Whole-Population Study // The Lancet Diabetes & Endocrinology. 2020. Vol. 8, N 10. Pp. 813–822. DOI: 10.1016/S2213-8587(20)30272-2

8. Brooks S.K., Webster R.K., Smith L.E. [et al.]. the psychological impact of quarantine and how to reduce it: rapid review of the evidence // Lancet. 2020. Vol. 395, N 10227. Pp. 912–920. DOI: 10.1016/S0140-6736(20)30460-8

9. Büyükbayram Z., Aksoy M., Güngör A. Investigation of the perceived stress levels and adherence to treatment of individuals with type 2 diabetes during the COVID-19 pandemic // Archives of Health Science & Research. 2022. Vol. 9, N 1. Pp. 61–69. DOI: 10.5152/ArcHealthSciRes.2022.21088

10. Chia L.R., Schlenk E.A., Dunbar-Jacob J. Effect of personal and cultural beliefs on medication adherence in the elderly // Drugs & Aging. 2006. Vol. 23, N 3. Pp. 191–202. DOI: 10.2165/00002512-200623030-00002

11. Citoni B., Figliuzzi I., Presta V. [et al.]. Home Blood Pressure and Telemedicine: A Modern Approach for Managing Hypertension During and Alfer COVID-19 Pandemic // High blood pressure & cardiovascular prevention: the official journal of the Italian Society of Hypertension. 2022. Vol. 29, N 1. Pp. 1–14. DOI: 10.1007/s40292-021-00492-4

12. da Luz Pádua Guimarães M.C., Coelho J.C., Dos Santos J. [et al.]. Adherence to antihypertensive treatment during the COVID-19 pandemic: ndings from a cross-sectional study // Clinical hypertension. 2022. Vol. 28, N 1. Pp. 35. DOI: 10.1186/s40885-022-00219-0

13. Degli Esposti L., Buda S., Nappi C. [et al.]. Implications of COVID-19 Infection on Medication Adherence with Chronic therapies in Italy: A Proposed Observational Investigation by the Fail-to-Rell Project // Risk management and healthcare policy. 2020. Vol. 13. Pp. 3179–3185. DOI: 10.2147/RMHP.S265264

14. Dhruve H., d’Ancona G., Holmes S. [et al.]. Prescribing patterns and treatment adherence in patients with asthma during the COVID-19 pandemic // the Journal of Allergy & Clinical Immunology. In Practice. 2022. Vol. 10, N 1. Pp. 100–107.e2. DOI: 10.1016/j.jaip.2021.09.032

15. DiMatteo M.R. Social support and patient adherence to medical treatment: a meta-analysis // Health Psychology: official journal of the Division of Health Psychology, American Psychological Association. 2004. Vol. 23, N 2. Pp. 207–218. DOI: 10.1037/0278-6133.23.2.207

16. Elnaem M.H., Kamarudin N.H., Syed N.K. [et al.]. Associations between Socio-Demographic Factors and Hypertension Management during the COVID-19 Pandemic: Preliminary Findings from Malaysia // International journal of environmental research and public health. 2021. Vol. 18, N 17. Pp. 9306. DOI: 10.3390/ijerph18179306

17. Franco D.W., Alessi J., Becker A.S. [et al.]. Medical adherence in the time of social distancing: a brief report on the impact of the COVID-19 pandemic on adherence to treatment in patients with diabetes // Archives of endocrinology and metabolism. 2021. Vol. 65, N 4. Pp. 517–521. DOI: 10.20945/2359-3997000000362

18. Fukutani E., Wakahara K., Nakamura S. [et al.]. Inhalation adherence for asthma and COPD improved during the COVID-19 pandemic: a questionnaire survey at a university hospital in Japan // the Journal of asthma: official journal of the Association for the Care of Asthma. 2023. Vol. 60, N 11. Pp. 2002–2013. DOI: 10.1080/02770903.2023.2209173

19. Gómez-Escalonilla Lorenzo S., Martínez I., Notario Pacheco B. Influence of COVID-19 on treatment adherence and psychological well-being in a sample of hypertensive patients: a cross-sectional study // BMC psychiatry. 2023. Vol. 23, N 1. Pp. 121. DOI: 10.1186/s12888-022-04473-2

20. Guimaraes M.C.L.P., Coelho J.C., Dos Santos J. [et al.]. Adherence to anti-hypertensive treatment on the COVID-19 pandemic // Journal of Hypertension. 2021. Vol. 39. Pp. e404. DOI: 10.1097/01.hjh.0000749272.99434.67

21. Gul Z.B., Atakli H.D. Effect of the COVID-19 pandemic on drug compliance and stigmatization in patients with epilepsy // Epilepsy & Behavior. 2021. Vol. 114. Pp. 107610. DOI: 10.1016/j.yebeh.2020.107610

22. Hassan S.U., Zahra A., Parveen N. [et al.]. Quality of Life and Adherence to Healthcare Services during the COVID-19 Pandemic: A Cross-Sectional Analysis // Patient preference and adherence. 2022. Vol. 16. Pp. 2533– 2542. DOI: 10.2147/PPA.S378245

23. Heumann M., Zabaleta-Del-Olmo E., Röhnsch G., Hämel K. “Talking on the Phone Is Very Cold” – Primary Health Care Nurses’ Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic // Healthcare (Basel, Switzerland). 2022. Vol. 10, N 12. Pp. 2436. DOI: 10.3390/healthcare10122436

24. Jordan R.E., Adab P., Cheng K.K. Covid-19: Risk Factors for Severe Disease and Death // BMJ. 2020. Vol. 368. Pp. m1198. DOI: 10.1136/bmj.m1198

25. Kaye L., theye B., Smeenk I. [et al.]. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic // the Journal of Allergy & Clinical Immunology. In Practice. 2020. Vol. 8, N 7. Pp. 2384–2385.

26. Laba T.-L., Lehnbom E., Brien J.A., Jan S. Understanding if, how and why non-adherent decisions are made in an Australian community sample: a key to sustaining medication adherence in chronic disease? // Research in Social & Administrative Pharmacy. 2015. Vol. 11, N 2. Pp. 154–162. DOI: 10.1016/j.sapharm.2014.06.006

27. Landstra C.P., de Koning E.J.P. COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course // Frontiers in Endocrinology. 2021. Vol. 12. Pp. 649525. DOI: 10.3389/fendo.2021.649525

28. Liu L., Silva Almodóvar A., Nahata M.C. Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic // therapeutic advances in chronic disease. 2023. Vol. 14. Pp. 20406223231205796. DOI: 10.1177/20406223231205796

29. Mathieu C., Bezin J., Pariente A. Impact of COVID-19 epidemic on antihypertensive drug treatment disruptions: results from a nationwide interrupted time-series analysis // Frontiers in Pharmacology. 2023. Vol. 14. Pp. 1129244. DOI: 10.3389/fphar.2023.1129244

30. McGowan P.T. Self-management education and support in chronic disease management // Primary Care. 2012. Vol. 39, N 2. Pp. 307–325. DOI: 10.1016/j.pop.2012.03.005

31. Menon S., Sander J.W. Effects of the COVID-19 pandemic on medication adherence: In the case of antiseizure medications, A scoping review // Seizure. 2021. Vol. 93. Pp. 81–87. DOI: 10.1016/j.seizure.2021.10.009

32. Midão L., Almada M., Carrilho J. [et al.]. Pharmacological Adherence Behavior Changes during COVID-19 Outbreak in a Portugal Patient Cohort // International Journal of Environmental Research and Public Health. 2022. Vol. 19, N 3. Pp. 1135. DOI: 10.3390/ijerph19031135

33. Mueller T.M., Kostev K., Gollwitzer S. [et al.]. the impact of the coronavirus disease (COVID-19) pandemic on outpatient epilepsy care: an analysis of physician practices in Germany // Epilepsy & Behavior. 2021. Vol. 117. Pp. 107833. DOI: 10.1016/j.yebeh.2021.107833

34. Nouira N., Bahria W., Hamdi D. [et al.]. Medication adherence in Elderly during COVID-19 pandemic: what role can the emergency department play? // the Pan African medical journal. 2021. Vol. 38. Pp. 220. DOI: 10.11604/ pamj.2021.38.220.26555

35. Phillips L.A., Leventhal H., Leventhal E.A. Assessing theoretical predictors of long-term medication adherence: Patients’ treatment-related beliefs, experiential feedback and habit development // Psychology & Health. 2013. Vol. 28, N 10. Pp. 1135–1151. DOI: 10.1080/08870446.2013.793798

36. Roberts M.K., Ehde D.M., Herring T.E., Alschuler K.N. Public health adherence and information-seeking for people with chronic conditions during the early phase of the COVID-19 pandemic // PM&R. 2021. Vol. 13, N 11. Pp. 1249–1260. DOI: 10.1002/pmrj.12668

37. Rodríguez I., López-Caro J.C., Gonzalez-Carranza S. [et al.]. Adherence to inhaled corticosteroids in patients with asthma prior to and during the COVID-19 pandemic // Scientic reports. 2023. Vol. 13, N 1. Pp. 13086. DOI: 10.1038/s41598-023-40213-6

38. Santi R.L., Márquez M.F., Piskorz D. [et al.]. Ambulatory Patients with Cardiometabolic Disease and Without Evidence of COVID-19 during the Pandemic. the CorCOVID LATAM Study // Global heart. 2021. Vol. 16, N 1. Pp. 15. DOI: 10.5334/gh.932

39. Shimels T., Asrat Kassu R., Bogale G. [et al.]. Magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Ethiopia during the COVID-19 pandemic // PloS one. 2021. Vol. 16, N 4. Pp. e0249222. DOI: 10.1371/journal.pone.0249222

40. Steiner J.F., Powers J.D., Malone A. [et al.]. Hypertension care during the COVID-19 pandemic in an integrated health care system // the Journal of Clinical Hypertension. 2023. Vol. 25. Pp. 315–325. DOI: 10.1111/jch.14641

41. Stilley C.S., Sereika S., Muldoon M.F. [et al.]. Psychological and cognitive function: predictors of adherence with cholesterol lowering treatment // Annals of Behavioral Medicine: a publication of the Society of Behavioral Medicine. 2004. Vol. 27, N 2. Pp. 117–124. DOI: 10.1207/s15324796abm2702_6

42. Strizović S., Vojvodić N., Kovačević M. [et al.]. Influence of COVID-19 pandemic on quality of life in patients with epilepsy – Follow-up study // Epilepsy & Behavior. 2021. Vol. 121. Pp. 108026.

43. Taillé C., Roche N., Tesson F. [et al.]. Belief and adherence to COVID 19-lockdown restrictions in patients with asthma versus other chronic diseases: results from a cross-sectional survey nested in the ComPaRe e-cohort, in France // the Journal of asthma: official journal of the Association for the Care of Asthma. 2022. Vol. 59, N 8. Pp. 1491–1500. DOI: 10.1080/02770903.2021.1941091

44. theolou P., Panagiotaki H. A literature review to investigate the link between psychosocial characteristics and treatment adherence in cancer patients // Oncology Reviews. 2012. Vol. 6, N 1. Pp. e5. DOI: 10.4081/oncol.2012.e5

45. United Nations: Chronic diseases taking ‘immense and increasing toll on lives’, warns WHO. 2023. [Электронный ресурс.] https://news.un.org/en/story/2023/05/1136832 (дата обращения: 12.01.2024).

46. Verma M., Sharma P., Chaudhari A. [et al.]. Effect of Lockdown on Diabetes Care During the COVID-19 Pandemic: Result of a Telephone-Based Survey Among Patients Attending a Diabetic Clinic in Northern India // Cureus. 2021. Vol. 13, N 10. Pp. e18489. DOI: 10.7759/cureus.18489

47. Volpato E., Ban P., Pagnini F. the Interaction between Asthma, Emotions, and Expectations in the Time of COVID-19 // Journal of asthma and allergy. 2023. Vol. 16. Pp. 1157–1175. DOI: 10.2147/JAA.S418840

48. World Health Organisation: Adherence to long-term therapies, evidence for action / World Health Organisation. Geneva: WHO, 2003. 230 p.

49. World Health Organisation: Noncommunicable diseases. 2023. [Электронный ресурс.] https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (дата обращения: 12.01.2024).

50. World Health Organisation: WHO COVID-19 dashboard. 2023. [Электронный ресурс.] https://data.who.int/ dashboards/covid19/cases?n=c (дата обращения: 12.01.2024).

51. Zahmatkeshan N., Khademian Z., Zarshenas L., Rakhshan M. Experience of adherence to treatment among patients with coronary artery disease during the COVID-19 pandemic: A qualitative study // Health promotion perspectives. 2021. Vol. 11, N 4. Pp. 467–475. DOI: 10.34172/hpp.2021.59

52. Zhang H.Q., Lin J.Y., Guo Y. [et al.]. Medication adherence among patients with chronic obstructive pulmonary disease treated in a primary general hospital during the COVID-19 pandemic // Annals of translational medicine. 2020. Vol. 8, N 18. Pp. 1179. DOI: 10.21037/atm-20-6016

53. Zhao C., Batio S., Lovett R. [et al.]. the Relationship between COVID-19 Related Stress and Medication Adherence among High-Risk Adults during the Acceleration Phase of the US Outbreak // Patient preference and adherence. 2021. Vol. 15. Pp. 1895–1902. DOI: 10.2147/PPA.S310613

54. Zhou F., Yu T., Du R. [et al.]. Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study // Lancet. 2020. Vol. 395, N 10229. Pp. 1054–1062. DOI: 10.1016/ S0140-6736(20)30566-3