Evaluation And Analysis Of Treatment Compliance And Effect Of Coronary Heart Disease Patients In Rural Areas Based On Continuous Intervention Of General Practitioners

Objective: To explore the effect of continuous intervention of general practitioners on the treatment compliance and treatment effect of patients with coronary heart disease in rural areas,further proving the important role of general practitioners in the whole process of cardiovascular disease prevention and treatment.Methods: Using its own before-and-after controlled study design,A total of 101 patients with coronary heart disease admitted to Yixian People’s Hospital from June 2020 to July2021 were selected as research objects,General practitioners used the concept of general practice and the person-centered continuous service method to provide comprehensive guidance on secondary prophylactic medication guidance and lifestyle intervention for patients,Continuous intervention and follow-up for 3 months,coronary heart disease risk factor control questionnaire,Seattle Angina Questionnaire and Morisky Medication adherence Scale were used to understand the control of coronary heart disease risk factors,body function and quality of life,medication compliance and its influencing factors,and to analyze the correlation between medication compliance and risk factor control and quality of life.Results: 1、101 patients with coronary heart disease were included in this study,of which49.5% were males(50/101)and 50.50% were females(51/101).The mean age of patients was(64.20±8.79)years old,≥65 years old accounted for 51.5%(52/101);21.78%(22/101) of those with high school education or above,44.55%(45/101)of those with middle school education,33.66%(34/101)of those with primary school education or below;Single,double and triple coronary arteries were involved in 44.55%(45/101),30.69%(31/101)and 24.75%(25/101),respectively,and 20.79%(21/101)of the patients underwent PCI stent implantation.2、After continuous intervention by general practitioners for 3 months,the levels of systolic blood pressure,diastolic blood pressure,fasting blood glucose and low density lipoprotein cholesterol in 101 patients with coronary heart disease were 136.46±14.29、78.68±9.4、5.99±1.07 and 2.43±0.66,respectively,which were significantly decreased compared with before intervention,and the differences were statistically significant.Seattle Angina Questionnaire scores on all dimensions:physical limitation(65.90±10.09),anginal stability(94.80±16.70),anginal frequency(87.33±15.93),treatment statisfaction(70.65±10.00),disease perception(52.48±11.82).Compared with before intervention,the scores were improved,and the difference was statistically significant(P<0.05).It indicates that the continuity and comprehensive care of general practitioners can improve the risk factors,body function and life quality of patients with coronary heart disease.3、After continuous intervention by general practitioners for 3 months,the medication compliance level of 101 patients with coronary heart disease before and after intervention was 4.53±1.06 and 6.23±1.12,respectively,which was significantly improved after intervention,and the difference was statistically significant compared with before intervention(P<0.05),but still at a moderate level.It can be seen from the investigation that the main missing items in the score of patients’ medication compliance are item 1,item 6 and item 8,that is,forgetting to use drugs,stopping drugs on their own when they feel their condition is under control,and having difficulty in remembering all the current therapeutic drugs.Multiple linear regression results show that: The higher the education level,the higher the score of medication compliance(B=0.341>0,P=0.006).It is indicated that the education level of patients is the main factor affecting the medication compliance of patients.4、Pearson correlation analysis showed that medication compliance score was negatively correlated with LDL-C(r=-0.258,P=0.009),positively correlated with the degree of physical restriction(r=0.243,P=0.014),and positively correlated with the stable state of angina pectoris(r=0.333,P=0.001).Conclusion: After continuous intervention by general practitioners,the risk factor control rate of coronary heart disease patients in rural areas was significantly improved;The anginal stability and quality of life of patients were significantly improved.In the intervention patients,medication compliance was significantly improved,and there was a negative correlation with LDL-C level,and a positive correlation with the degree of physical restriction and the improvement of angina stable state.However,overall patient medication compliance remains at a moderate level,with room for improvement.