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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinvest</journal-id><journal-title-group><journal-title xml:lang="ru">Качественная клиническая практика</journal-title><trans-title-group xml:lang="en"><trans-title>Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2588-0519</issn><issn pub-type="epub">2618-8473</issn><publisher><publisher-name>ООО «Издательство ОКИ</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.37489/2588-0519-2024-2-16-32</article-id><article-id custom-type="edn" pub-id-type="custom">BGSXJG</article-id><article-id custom-type="elpub" pub-id-type="custom">clinvest-714</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НОВЫЕ МЕДИЦИНСКИЕ ТЕХНОЛОГИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>NEW HEALTH TECHNOLOGY</subject></subj-group></article-categories><title-group><article-title>Единая медицинская информационно-аналитическая система (ЕМИАС) как инструмент для нового уровня понимания и диагностики приверженности фармакотерапии у пациентов, перенёсших инфаркт миокарда, в амбулаторной практике г. Москвы</article-title><trans-title-group xml:lang="en"><trans-title>Electronic medical information and analytical system (EMIAS) as a tool for the new level of understanding and diagnosis of medication adherence in patients with myocardial infarction in primary care practice in Moscow</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8395-419X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фитилёв</surname><given-names>С. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Fitilev</surname><given-names>S. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фитилёв Сергей Борисович - д. м. н., профессор</p><p>Москва</p></bio><bio xml:lang="en"><p>Sergey B. Fitilev - Dr. Sci. (Med.), professor</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2687-5986</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Возжаев</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vozzhaev</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Возжаев Александр Владимирович - д. фарм. н., профессор</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexander V. Vozzhaev - Dr. Sci. (Pharm.), professor, Department of General and Clinical Pharmacology</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0070-3115</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шкребнёва</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Shkrebniova</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шкребнёва Ирина Ивановна - к. м. н., доцент</p><p>Москва</p></bio><bio xml:lang="en"><p>Irina I. Shkrebniova - PhD, Cand. Sci. (Med.), associate professor, Department of General and Clinical Pharmacology</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2400-3938</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Клюев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kliuev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Клюев Дмитрий Алексеевич - к. фарм. н., ассистент</p><p>Москва</p></bio><bio xml:lang="en"><p>Dmitry A. Kliuev - PhD, Cand. Sci. (Pharm.), assistant professor, Department of General and Clinical Pharmacology</p><p>Moscow</p></bio><email xlink:type="simple">kliuev_da@pfur.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6012-8917</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Саакова</surname><given-names>Л. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Saakova</surname><given-names>L. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Саакова Люсинэ Наириевна - ординатор</p><p>Москва</p></bio><bio xml:lang="en"><p>Liusine N. Saakova - resident, Department of General and Clinical Pharmacology</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-5245-3791</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оваева</surname><given-names>А. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Ovaeva</surname><given-names>A. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оваева Анна Олеговна - заведующий лабораторией</p><p>Москва</p></bio><bio xml:lang="en"><p>Anna O. Ovaeva - laboratory manager, Department of General and Clinical Pharmacology</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»; ГБУЗ «Городская поликлиника №2 Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Peoples' Friendship University of Russia named after Patrice Lumumba</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>25</day><month>06</month><year>2024</year></pub-date><volume>0</volume><issue>2</issue><fpage>16</fpage><lpage>32</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Фитилёв С.Б., Возжаев А.В., Шкребнёва И.И., Клюев Д.А., Саакова Л.Н., Оваева А.О., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Фитилёв С.Б., Возжаев А.В., Шкребнёва И.И., Клюев Д.А., Саакова Л.Н., Оваева А.О.</copyright-holder><copyright-holder xml:lang="en">Fitilev S.B., Vozzhaev A.V., Shkrebniova I.I., Kliuev D.A., Saakova L.N., Ovaeva A.O.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.clinvest.ru/jour/article/view/714">https://www.clinvest.ru/jour/article/view/714</self-uri><abstract><p>Актуальность. Мировое сообщество всё чаще использует информацию о реализации пациентами выписанных рецептов на лекарственные препараты, как доминирующий метод оценки приверженности фармакотерапии, что послужило основанием для проведения настоящей работы.Цель. Адаптировать существующий международный опыт применения цифровых технологий для оценки приверженности фармакотерапии к реальным условиям отечественного здравоохранения на амбулаторном этапе.Материал и методы. Проведено ретроспективное исследование приверженности статинотерапии пациентов, перенёсших инфаркт миокарда (ИМ), на базе крупного амбулаторного учреждения г. Москвы, состоявшее из 2‑х этапов: 1‑й этап — обобщение международного опыта изучения приверженности с применением метода учёта реализованных рецептов; 2‑ой этап — апробация метода учёта реализации электронных рецептов (УРЭР) для оценки приверженности. Производился расчёт доли дней, обеспеченных статинотерапией (показатель PDC) за 12‑месячный период наблюдения.Объект исследования — электронные медицинские карты пациентов (регистрация данных демографии, анамнеза, липидного профиля, рецептурных назначений статинов), находившихся на диспансерном наблюдении после перенесённого ИМ за период с 1 января по 31 декабря 2022 г. Согласно критериям отбора было включено 109 пациентов.Результаты. Анализ международного опыта показал, что метод учёта реализованных рецептов получил широкую распространённость в последние десятилетия в зарубежных странах и зарекомендовал себя как объективный, неинвазивный и дешёвый метод оценки приверженности. Изучение приверженности статинотерапии у постинфарктных больных методом УРЭР выявило среднее значение PDC = 63,0±29,7 %. Оптимально приверженными статинотерапии (PDC≥80 %) на протяжении всего периода наблюдения оказались 38 % пациентов. При раздельной оценке PDC за 1‑е и 2‑е полугодия периода наблюдения обнаружено, что доля больных с оптимальной приверженностью уменьшилась на 17,6 % (р=0,04). Приверженность коррелировала с эффективностью статинотерапии — более выраженное снижение ХС-ЛПНП наблюдалось у пациентов с PDC≥80 % по сравнению с недостаточно приверженными (–1,47±1,09 против –0,96±1,16 ммоль/л; р=0,043).Заключение. Проведённое исследование продемонстрировало работоспособность и информативность метода УРЭР в практике отечественного амбулаторного звена. Данный метод, при условии его доработки, может быть интегрирован в ЕМИАС для рутинной оценки врачами приверженности пациентов фармакотерапии.</p></abstract><trans-abstract xml:lang="en"><p>Introduction. The global community is increasingly using patients' prescription claims data as a dominant method for assessing medication adherence, which encouraged us to conduct this study.Aim. To adapt the existing international experience of using digital technologies to measure medication adherence to the routine practice of domestic health care at the outpatient level.Methods. We conducted a retrospective study of adherence to statin therapy in patients with myocardial infarction (MI) at a large primary care clinic in Moscow, which included 2 stages: 1st stage — compilation of international experience on medication adherence studies using pharmacy dispensing records; 2nd stage — testing the method of electronic prescription refill record to measure adherence. We calculated the proportion of days covered (PDC) by statin therapy over a 12‑month period following MI. Data on demography, anamnesis, lipid profile, and statin prescriptions were obtained from the electronic medical records of patients with acute MI from January 1 — December 31, 2022. A total of 109 patients were included according to the prespecified selection criteria.Results. An analysis of international experience demonstrated that the pharmacy dispensing record method has become widespread in recent decades in foreign countries and has established itself as an objective, noninvasive, and inexpensive method for measuring medication adherence. The study of adherence to statin therapy in post-MI patients using the electronic prescription refill record method revealed a mean PDC = 63.0±29.7 %. Optimal adherence (PDC≥80 %) throughout the 12‑month follow-up period was noted in 38 % of patients. When PDC was calculated separately for the 1st and 2nd half year, it was found that the proportion of patients with optimal adherence decreased by 17.6 % (p=0.04). Adherence correlated with the efficacy of statin therapy — a more pronounced reduction of LDL–C was observed in patients with PDC≥80 % compared with those who were insufficiently adherent (–1.47±1.09 vs –0.96±1.16 mmol/L; p=0.043).Conclusion. This study demonstrated the efficiency and information value of an electronic prescription refill record system for domestic primary care. After operational tuning, the proposed method can be integrated into EMIAS for routine medication adherence assessment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ЕМИАС</kwd><kwd>инфаркт миокарда</kwd><kwd>приверженность лечению</kwd><kwd>статинотерапия</kwd><kwd>учёт реализованных рецептов</kwd><kwd>PDC</kwd><kwd>амбулаторное лечение</kwd><kwd>доля обеспеченных дней</kwd></kwd-group><kwd-group xml:lang="en"><kwd>EMIAS</kwd><kwd>medication adherence</kwd><kwd>myocardial infarction</kwd><kwd>pharmacy refill records</kwd><kwd>prescription claims data</kwd><kwd>statin therapy</kwd><kwd>PDC</kwd><kwd>ambulatory treatment</kwd><kwd>proportion of days covered</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">EUROASPIRE II Study Group. 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