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 Medicine», 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 average), 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 Azerbaijan, 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 hospitalization, partial difficulties prevailed in the rest of the cases. An incomplete coverage by doctors in the staffing list in the analyzed countries has been noted, and there has been a significant shortage of doctors in the Russian Federation and Republic of Kazakhstan. 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.
