Сompliance patients with chronic аcalculous cholecystitis, which оperative treatment

Ben Amara Brahmi Noamen

Abstract


Introduction. Chronic cholecystitis without stones — one of the most common diseases of the digestive system and occurs with a frequency of 6 — 7 per 1000 people. Patients have high rates of temporary and permanent disability. In the practice of medicine is crucial compliance — voluntary adherence to the patient's physician's recommendation.
Objective: To evaluate the adherence to the treatment of patients with chronic acalculous cholecystitis, which operative treatment, compared with patients in the control group.
Material and methods. The results of a comprehensive study of compliance in 114 patients with chronic acalculous cholecystitis (croup I), which shows the operation treated at the clinic for the last 7 years. Women was — 67 (59.1%), men — 47 (40.9%) aged 43,0 ± 6,7 years. Control group (group II) consisted of 40 patients of similar age and sex without biliary pathology. Various comorbidities were detected in 71 (62.1%) patients. To confirm the diagnosis, the following survey methods: clinical, laboratory, ultrasound (with the study of the function of the gallbladder), fractional chromatic duodenal intubation with a microscopic, biochemical and bacteriological studies of bile, CT or magnetic resonance imaging (if indicated), and statistical. To describe adherence to treatment we offer patients answer 11 specific questions.
Results and discussion. Analysis of the responses to the questionnaire showed that 82.3% of the patients I group ready to perform all medical appointments, and in the II group — 68.5%. The following response rates will apply to groups I and II, respectively. Able to purchase medicines worth about 1000 uan — 77% and 81.4%. Lack of money prevents the full implementation of all medical prescriptions — 52% and 47.5%, disbelief doctor — 10% and 40.7% (p < 0.01). The average monthly income of patients differed slightly: 2390 uan and 2224 uan. Relatives are able to provide financial support during the patient's illness — 30% and 55% (p < 0.05), are not able to — 66% and 40% (p < 0.05). Compliance with dietary recommendations statistically significant for group I patients (74.5%) than in group II (48.4%) — p < 0.05. Patients II group statistically significantly more focused on modern high-quality treatment — 78% and 96% (p < 0.05). Higher estimate of the previous treatment of acute illness, patients were given the II group — 67.1% and 81.4% (p < 0.05). Approximately half of the patients in both groups would like to reduce the cost of treatment — 49% and 47%. More strictly adhere to the dietary recommendations of the group II patients — 57.1% and 64.3% (p < 0.05). To the necessity of long-term use of drugs are: good — 47% and 65%, satisfactory — 27.4% and 11% (p < 0.05) and negatively — 25.6% and 23.9%.
Conclusions. Adherence to adjuvant therapy in patients with chronic аcalculous cholecystitis, which operative treatment, high (82.1%), while in the control group — the average (68%). To improve сompliance patients it is advisable to systematically inform them of severe complications in the long course of the disease.


Keywords


compliance; chronic cholecystitis without stones; surgery

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DOI: https://doi.org/10.22141/1997-2938.3-4.26-27.2014.83231

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