| Abstrakt: |
Attitude of district internists to the realization of a concept of secondary prevention (SP) of ischemic heart disease was studied in one of large cities in Russia. Among preparations most necessary for SP the following were named: b-blockers (79.5%), angiotensin converting enzyme inhibitors (49.3%), antiaggregants (43.8%), hypolipidemic drugs (13.7%), nitrates (63%), biologically active supplements, phyto-preparations, metabolic drugs, and glycosides (3-5% each). However actually prescribed drugs were b-blockers (100%), nitrates (96%), angiotensin converting enzyme inhibitors (89%), calcium antagonists (87%), antiaggregants (83%), cardiac glycosides (66%), vitamins (39%). Average doses of drugs were low: 21.7, 47.4 and 35.5% of possible maximal doses for statins, angiotensin converting enzyme inhibitors, and beta-blockers, respectively. Nondrug measures were used "rarely" and "often" by 26 and 74% of physicians, respectively. Only 18% of physicians directed their patients to corresponding specialists. Recommendations were mostly formal, without explanation of goals, methods and specific features of recommended measures. Moreover their prescription by physician was determined largely by subjective factors: availability of sufficient time (50%), cultural level of a patient (79%), patient's own initiative (33%), physician's personal attitude to a patient (21%). |
