A perioperative phlebotropic therapy compliance study in patients with varicose veins
https://doi.org/10.21518/1995-1477-2020-1-2-81-88
Abstract
Introduction: Lower extremity varicose vein disease is one of the common problems in vascular surgery. Clinically, this disease is accompanied by a wide range of complaints and external symptoms, which eventually lead to a worse patients’ quality of life. The integrated approach is being applied to the disease treatment, which involves the use of various phlebotropic drugs as conservative therapy along with minimally invasive surgical correction and sclerotherapy.
Objective: to improve the quality of phlebotropic therapy for patients with lower extremity varicose vein disease, based on the study of factors that shape the patient’s compliance with the effective treatment of clinical symptoms. The term «compliance» means the precise and informed implementation of the doctor’s recommendations during the treatment by the patient. Most often, «compliance» is assessed by the drug use index, which is the quotient of dividing the number of days on which the full dose of the drug was taken by the duration of the entire study period. Materials and methods: The analysis of 368 + 111 patients with lower extremity varicose vein disease was carried out. Of these, 111 patients turned out to be beyond the correct study of compliance (a phlebectomy was performed in a hospital). 368 patients were divided into the following groups: Group 1: the patients, who were assigned modern surgical treatment of varicose veins (endovenous laser coagulation, scleroobliteration); Group 2: the patients, who withdrew from assigned interventions. As it turned out, the different groups of patients differed in compliance.
Results. The patients who were shown and performed surgical treatment – 320 (86.9%), can be considered highly compliant with the prescribed conservative therapy – the average value of the compliance index is 0.83, compared to the representatives who refused to perform the recommended surgical procedures recommended by them – 48 (13.1%), the compliance index is 0.78.
In the course of the investigation, the factors shaping compliance with phlebotropic drugs were identified, a comparative assessment was carried out on the main indicators of the effectiveness of phlebotropic drugs.
Conclusion. Thus, the compliance of the patients suffering from LEVVV during the treatment with phlebotropic drugs varies depending on the multiplicity and convenience of the form of the drug, on the effectiveness of the proposed phlebotropic therapy according to the influence on the complaints and symptoms, on the psychological readiness of the patient to entrust the result of the final treatment of the disease to the surgeon.
About the Authors
S. N. ZhabinRussian Federation
Sergei N. Zhabin, Cand. of Sci. (Med.), Associate Professor, Chair for Surgical Diseases No. 1
3, Karl Marx St., Kursk, 305041, Russia, 305041
A. A. Shitikov
Russian Federation
Alexander A. Shitikov, Physician - Clinical Pharmacologist
45a, Sumskaya St., Kursk, Russia, 305007
A. V. Tsukanov
Russian Federation
Andrei V. Tsukanov, Cand. of Sci. (Med.), Associate Professor, Chair for Surgical Diseases No. 1
3, Karl Marx St., Kursk, 305041, Russia, 305041
E. G. Obedkov
Russian Federation
Evgenij G. Obedkov, Cand. of Sci. (Med.), Teaching Assistant, Chair for Surgical Diseases No. 1
3, Karl Marx St., Kursk, 305041, Russia, 305041
S. S. Dudchenko
Russian Federation
Svetlana S. Dudchenko, Postgraduate Student, Chair for Surgical Diseases No. 1
3, Karl Marx St., Kursk, 305041, Russia, 305041
V. A. Murenova
Russian Federation
Valeriya A. Murenova, First-Year Resident, Chair for Ophthalmology
85, Pobedy St., Belgorod, Russia, 308015
A. D. Khizhnyak
Russian Federation
Anna D. Khizhnyak, First-Year Resident, Chair for Obstetrics and Gynecology
3, Karl Marx St., Kursk, 305041, Russia, 305041
K. E. Belova
Russian Federation
Kristina E. Belova, Sixth-Year Student, General Medicine Faculty
3, Karl Marx St., Kursk, 305041, Russia, 305041
References
1. Shevchenko Yu.L., Stoyko Yu.M., Lytkin M.I. Basics of clinical phlebology. 2 nd ed. Moscow: Meditsina; 2013. 312 p. (In Russ.)
2. Bogachev V.Yu., Kirienko A.I., Zolotukhin I.A., Bryushkov A. Yu., Zhuravleva O.V. Endovasal laser obliteration of the greater saphenous vein in patients with varicosis. Angiologiya i sosudistaya khirurgiya = Angiology and vascular surgery. 2004;10(1):93–97. (In Russ.) Available at: http://www.angiolsurgery.org/magazine/2004/1/13.htm.
3. Shevchenko Yu.L., Stoyko Yu.M., Mazayshvili K.V. Laser surgery of varicose disease. 3 nd ed. Moscow: Borges; 2010. 196 p. (In Russ.)
4. Goldman M.P., Mauricio M. Intravenous 1320-nm Laser Closure of the Great Saphenous Vein: A 6- to 12-Month Follow-up Study. Dermatol Surg. 2004;30(11):1380–1385. doi: 10.1111/j.1524-4725.2004.30431.x.
5. Pannier F., Rabe E., Maurins U. First results with a new 1470-nm diode laser for endovenous ablation of incompetent saphenous veins. Phlebology. 2009;24(1):26–30. doi: 10.1258/phleb.2008.008038.
6. Savel’ev V.S., Pokrovskiy A.V., Kirienko A.I., Bogachev V.Yu., Bogdanets L.I., Sapelkin S.V. et al. Systemic therapy of venous trophic ulcers. Angiologiya i sosudistaya khirurgiya = Angiology and vascular surgery. 2002;8(4):47–53. (In Russ.) Available at: http://www.angiolsurgery.org/magazine/2002/4/7.htm.
7. Мin R.J., Khilnani N., Zimmet S.E. Endovenous laser treatment of saphenous vein reflux: long-term results. Journal of Vascular and Interventional Radiology. 2003;14(8):991–996. doi: 10.1097/01.rvi.0000082864.05622.e4.
8. Kirienko A.I. New technologies for the treatment of CVI – what do experts think of this? Phlebolymphologiya = Phlebolymphology. 2006;(27):15. (In Russ.)
9. Schwarz Yu.G., Naumova E.A. Adherence of patients to treatment from the positions of evidence−based medicine. Mezhdunarodnyy meditsinskiy zhurnal = International Medical Journal. 2005;11(3):120–125. (In Russ.) Available at: http://www.imj.kh.ua/archive/2005/3/26.
Review
For citations:
Zhabin S.N., Shitikov A.A., Tsukanov A.V., Obedkov E.G., Dudchenko S.S., Murenova V.A., Khizhnyak A.D., Belova K.E. A perioperative phlebotropic therapy compliance study in patients with varicose veins. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2020;(1-2):81-88. (In Russ.) https://doi.org/10.21518/1995-1477-2020-1-2-81-88

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.