title: [Adherence of patients with stable angina to treatment with trimetazidine MR and frequency of emergency medical care: results of the EFFECT study].
abstract: The adherence of patients with stable angina to antianginal therapy is the key factor of controlling the disease. The purpose of the study was to evaluate the relationship of adherence of patients with stable angina to treatment with trimetazidine modified release (MR) with frequency (risk) of emergency medical care. We consistently included in the study patients with stable angina in primary health care. The results of treatment for 16 weeks were monitored at patients with angina attacks three times per week or more, use of short nitrate and treatment with generic trimetazidine. To strengthen the antianginal therapy generic was replaced with original trimetazidine MR. Adherence is considered relatively high while taking 80-120% of the recommended dose of the drug (70 mg/day). The effectiveness of treatment evaluated by the frequency of emergency hospitalizations and/or ambulance calls because of the pain, discomfort, tightness in the chest or ischemic changes on the electrocardiogram. 870 patients were included in the study, the results of treatment in 185 were assessed. Patients with a relatively high adherence to trimetazidine MR (n=151) were used (median) 99% (98, 104), with low (&lt;80%, n=34) adherence - 67% (49, 76) of the recommended dose of the drug. During the study period, the primary end point is fixed in 7 (21%) patients with low and in 18 (12%) -  with relatively high adherence (p=0.182). The number of angina attacks, having necessitated taking short-nitrate, decreased in the groups, respectively, with 5 (3; 10) and 6 (4; 10) to 2 (1; 3) per week (p=0.791). Thus, replacing generic trimetazidine with original trimetazidine MR in patients with a high frequency of angina attacks can achieve significant antianginal effect. Adherence of patients to the reception of the drug by an average 1/3  below the recommended amount does not affect the risk of emergency hospitalizations and/or ambulance calls for 16 weeks.
authors.forename: M G
authors.initials: MG
authors.lastname: Glezer
authors.forename: R T
authors.initials: RT
authors.lastname: Saĭgitov
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D016903:Drug Monitoring / Q000379:methods; D057915:Drug Substitution / Q000706:statistics & numerical data; D004562:Electrocardiography; D004630:Emergencies / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D013810:Therapeutic Equivalency; D016896:Treatment Outcome; D014292:Trimetazidine / Q000008:administration & dosage / Q000493:pharmacokinetics; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000493:pharmacokinetics
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine