Possibilities and limitations of secondary prevention of chronic non-communicable diseases in primary care of Russia and CIS countries

Mamedov M.N. Mardanov B.U. Kutsenko V.A. Drapkina O.M. Balykova L.A. Druk I.V. Grigorovich M.S. Efremova E.V. Kanorsky S.G. Petrova M.M. Poponina T.M. Zolotovskaya I.A. Rubanenko O.A. Khaisheva L.A. Drobotya N.V. Iskenderov B.G. Nevzorova V.A. Umetov M.A. Kuznetsov A.A. Nikiforov V.S. Tyrenko V.V. Bursikov A.V. Manyugina E.A. Arabidze G.G. Mehdiev S.H. Kauizbay Z.A. Murkamilov I.T. Kezhun L.V. Yakubova L.V. Zholdin B.K. Seysembekov T.Z.
2024 Media Sphera Publishing Group

Profilakticheskaya Meditsina
2024 #27 Issue 11 54 - 62 pp.

Objective. To analyze the possibilities and limitations of implementation of secondary prevention of chronic non-communicable diseases (CNCDs) in primary care in cities in the Russian Federation and 4 CIS countries based on a survey of doctors. Material and methods. The study involved doctors of outpatient-polyclinic facilities from 16 cities in the Russian Federation and 6 major cities in 4 CIS countries (Kyrgyz Republic, Republic of Belarus, Republic of Kazakhstan, Republic of Azerbaijan). The survey was organized on a questionnaire prepared by «National Medical Research Center for Therapy and Preventive Medi-cine», which included 11 blocks of questions. Multiple choice for each question is provided. Results. Men aged 50—59 years prevailed among patients, who were observed in outpatient clinics of five countries. Men aged over 65 years made up 30 and 40% respectively in the samples from the Russian Federation and the Republic of Azerbaijan, and only one fifth — in the samples from the other three countries. Men aged 40—50 years were ranked second for frequency of uptake in the samples from Republic of Kazakhstan and Republic of Belarus. The frequency of uptake among women was comparable in the age ranges of 50—59 years, as well as 60—65 years and older in samples from the Russian Federation, Republic of Belarus and Republic of Azerbaijan. Chronic forms of ischemic heart disease ranked first among CNCDs in terms of uptake (56% on aver-age), the second place is occupied by the type 2 diabetes mellitus (27% on average). At least partial coverage by preferential drugs was provided according to the doctors in most of the considered samples from CIS countries; 100% coverage supplied the needs up to 40% in three CIS countries, this indicator was 2 times less in other countries. In the Kyrgyz Republic and Republic of Azer-baijan, 50% of the target level was reached. The situation was slightly better in the other three countries, with doctors reporting 75% of the target level reaching for the main risk factors. In all countries, about 30% of the cases were without problems with hos-pitalization, partial difficulties prevailed in the rest of the cases. An incomplete coverage by doctors in the staffing list in the ana-lyzed countries has been noted, and there has been a significant shortage of doctors in the Russian Federation and Republic of Ka-zakhstan. The similar picture has been observed regarding the nursing staff. Conclusion. Systematic screening and regular medical check-up of adults are necessary, especially in the age group of 40—49 years for men and 50—59 years for women with regard to the significant role of chronic non-communicable diseases in the development of complications and mortality in CIS countries. Measures to increase adherence to the treatment, that affects the achievement of target levels of major risk factors, should be taken. The increase of preferential provision of pharmaceutical products and the organization of health-promoting schools for patients with chronic non-communicable diseases are important measures. In most CIS countries, the increase of the staffing list coverage by doctors and nursing staff can improve the implementation of secondary prevention of chronic non-communicable diseases.

chronic non-communicable diseases , CIS countries , doctors , medical sociological survey , secondary prevention

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National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russian Federation
Ogarev Mordovian State University, Saransk, Russian Federation
Omsk State Medical University, Omsk, Russian Federation
Kirov State Medical University, Kirov, Russian Federation
Ulyanovsk State University, Ulyanovsk, Russian Federation
Kuban State Medical University, Krasnodar, Russian Federation
V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation
Siberian State Medical University, Tomsk, Russian Federation
Samara State Medical University, Samara, Russian Federation
Rostov State Medical University, Rostov-on-Don, Russian Federation
Penza Institute of Advanced Medical Training — branch of the Russian Medical Academy of Postgraduate Education, Penza, Russian Federation
Pacific State Medical University, Vladivostok, Russian Federation
H.M. Berbekov Kabardino-Balkarian State University, Nalchik, Russian Federation
Russian Scientific Center of Radiology, Moscow, Russian Federation
I.I. Mechnikov Northwestern State Medical University, St. Petersburg, Russian Federation
S.M. Kirov Military Medical Academy, St. Petersburg, Russian Federation
Ivanovo State Medical University, Ivanovo, Russian Federation
City clinical Hospital No. 7, Ivanovo, Russian Federation
Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
Azerbaijan State Institute of Advanced Medical Education named after A. Aliyev of the Ministry of Health, Azerbaijan
South Kazakhstan State Pharmaceutical Academy, Shymkent, Kazakhstan
Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek, Kyrgyzstan
Kyrgyz-Russian Slavic University named after the First President of the Russian Federation B.N. Yeltsin, Kyrgyzstan
Grodno State Medical University, Grodno, Belarus
West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
JSC «National Scientific Medical Center», Kazakhstan

National Medical Research Center for Therapy and Preventive Medicine
Ogarev Mordovian State University
Omsk State Medical University
Kirov State Medical University
Ulyanovsk State University
Kuban State Medical University
V.F. Voino-Yasenetsky Krasnoyarsk State Medical University
Siberian State Medical University
Samara State Medical University
Rostov State Medical University
Penza Institute of Advanced Medical Training — branch of the Russian Medical Academy of Postgraduate Education
Pacific State Medical University
H.M. Berbekov Kabardino-Balkarian State University
Russian Scientific Center of Radiology
I.I. Mechnikov Northwestern State Medical University
S.M. Kirov Military Medical Academy
Ivanovo State Medical University
City clinical Hospital No. 7
Russian Medical Academy of Postgraduate Education
Azerbaijan State Institute of Advanced Medical Education named after A. Aliyev of the Ministry of Health
South Kazakhstan State Pharmaceutical Academy
Kyrgyz State Medical Academy named after I.K. Akhunbaev
Kyrgyz-Russian Slavic University named after the First President of the Russian Federation B.N. Yeltsin
Grodno State Medical University
West Kazakhstan Marat Ospanov Medical University
JSC «National Scientific Medical Center»

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