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Table 2 Characteristics of included studies on adherence to antihypertensive therapy in adult population in Russia from 2000 to 2017

From: Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017

Reference Year of publication Study setting Participant selection criteria Design Sample size Age (years) HT gradea Critical appraisal/quality assessment of findings
(a) Strengths
(b) Weaknesses
Ageev et al. [11] 2008 Patients who visited outpatient department of the Russian Cardiology Scientific and Production Center Men or women older than 18, with SBP 140–179 mmHg, DBP 99–100 mmHg, high cardiovascular risk, not taking of ACE inhibitors and diuretics, without secondary HT, heart failure, renal and hepatic impairment, insulin-treated DM.
Recruitment process not described
Randomized non-blinded controlled intervention study 60 62.5 ± 2.2 1–3 (a) prospective study, follow up period 6 mth;
(b) small sample size,
incorrect DBP level in inclusion criteria
Kobalava et al. [12, 13] 2011 Patients attending 240 cardiologists in 17 Regions Men or women with uncontrolled HT, non-adherent, absence of contraindications to ACE inhibitors taking, no eligibility to receive MAS Randomized non-blinded controlled intervention study 906 56.2 ± 10.6 (female)/ 54.9 ± 10.9 (male) Uncontrolled HTb (a) multicenter study, follow up period 12 mth, big sample size;
(b) including only non-adherent patients
Sarycheva et al. [14] 2017 Single outpatient clinic in Moscow Region.
300 patients have been examined before 150 patients included
Men or women aged 40–65, with ineffective treatment of HT and dyslipidemia, SBP > 140 mmHg, DBP > 90 mmHg, without IHD, DM and other severe diseases Randomized non-blinded controlled intervention study 150 40-65y HT patients with high cardiovascular risk (a) follow up period 12 mth;
(b) there are no basic data of adherence
Fofanova et al. [15] 2008 Patients who visited outpatient department of the Russian Cardiology Scientific and Production Center Men or women older than 18, with SBP 140–179 mmHg, DBP 99–100 mmHg, not taking of ACE inhibitors and diuretics, without secondary HT, heart failure, renal and hepatic impairment, insulin-treated DM. Recruitment process not described Randomized non-blinded controlled intervention study 60 61.2 ± 1.8 (female)/
61.8 ± 2.1 (male)
1–2 (a) patients with high and very high cardiovascular risk are included, for which adherence to therapy is particularly important, follow up period 6 mth;
(b) small sample size, incorrect DBP level in inclusion criteria
Karpov et al. [16] 2013 Patients attending any of 700 cardiologists in 51 Regions, each recruiting 3 patients Men or women older than 18, with uncontrolled HT on treatment. Recruitment process not described Prospective observational intervention study 2120 22–88 y 2–3 (a) big sample size, multicenter study;
(b) relatively short follow up period 3 mth and no control group
Glezer et al. [17] 2016 Patients attending 197 physicians in 48 Regions Men or women aged 18–79, with essential HT, SBP ≥140 mmHg, DBP ≥90, but <110 mmHg Prospective observational intervention study 940 56.5 ± 11.5 1–2 (a) big sample size, multicenter study;
(b) relatively short follow up period 3 mth, no control group
Glezer et al. [18] 2015 Patients attending 243 physicians in 51 Regions Men or women older than 18, with HT taking 2 or more antihypertensive drugs who have not reached their BP target, SBP 140–179 mmHg, DBP 90–109 mmHg, without contraindications to ACE inhibitors and calcium channel blockers Prospective observational intervention study 1351 included, 1061
completed the protocol
59.4 ± 11.1 Essential HT (a) big sample size, multicenter study;
(b) relatively short follow up period 3 mth, no control group
Glezer et al. [19] 2016 Patients attending 442 physicians in 29 cities Men or women older than 18, with HT on treatment who have not reached their BP target Prospective observational intervention study 1969 60.1 ± 0.3 No data (a) big sample size, multicenter study;
(b) relatively short follow up period 3 mth, no control group
Kagramanyan [20] 2015 Not stated
The author is affiliation at Yaroslavl State Medical University
Men or women aged 18–80, with grades 1–3 of HT, who visited the Municipal Clinical Hospital Prospective observational intervention study 50 64.06 ± 0.49 (female)/
61.88 ± 1.28 (male)
1–3 (a) studying of adherence in patients with 3 different socially significant nosologies - HT, asthma and alcohol abuse;
(b) small sample size, large age range, the real number of HT patients is represented incorrectly
Kaskaeva et al. [21] 2015 Not stated Male patients aged 20–64 with grades 1–3 of HT. Recruitment process not described Non-randomized comparison of 3 groups 250 20–64 y (male) 1–3 (a) patients of employable age + relationship adherence to job;
(b) described as randomized but groups selected on basis of employment: train drivers (112), other railway workers (50), non-railway workers (88)
Ushakova et al. [22] 2005 Regional cardiology clinic in Ivanovo city Men or women with grade 2 of HT on treatment, without IHD and DM Prospective observational intervention study 52 50.08 ± 7.25 2 (b) small sample size, no control group, patients with grade 2 of HT only included
Chazova et al. [23] 2014 Patients who visited outpatient department of the Russian Cardiology Scientific and Production Center Recruitment process not described Prospective observational intervention study 193 60.3 ± 8.0 No data (a) scope of sessions with patients, duration of sessions and number of the studying patients in group corresponded to the standards approved by the Ministry of Health, it is important for working at outpatient care settings;
(b) the control group is formed from abandoning the patient education, the number of patients in the control group is 2 times less than in the intervention group (65:128), short follow up period 6 weeks
Fofanova et al. [24] 2009 Patients attending 185 cardiologists in 84 policlinics of Moscow Men or women with SBP 140–179 or DBP 99–100 mmHg, not taking calcium channel blockers Cross-sectional 4816 62.2 ± 0.2 1–2 (a) big sample size;
(b) incorrect DBP level in inclusion criteria, only possible to extract baseline data
Donirova et al. [25] 2012 Ambulatory care facility Men or women with HT on treatment Cross-sectional 74 18 y and older No data (b) small sample size (14 vs 60)
Loukianov et al. [26] 2017 Patients attending 185 physicians or cardiologists of the same from 3 randomly selected outpatient clinics of Ryazan and the Ryazan region in March–May 2012 (consecutive inclusion of all who applied from March 01 to May 27) Patients older than 18, with combination of IHD, HT, chronic heart failure, permanent residence in the Ryazan and the Ryazan region Register 2303 70.3 ± 10.7 (ppl with history of MI),
69.9 ± 11.0 (ppl without history of MI)
1–3 (a) collection of adherence data using MMAS-4 in a large outpatient register
(b) all patients, irrespective of history of MI, had complex pathology of IHD, HT and chronic heart failure. Therefore it is impossible to estimate independent association between HT and adherence.
Fofanova et al. [27] 2014 Patients who visited outpatient department of the Russian Cardiology Scientific and Production Center Men and women with HT and examined by psychiatrists Cross-sectional 161 19–75 (female)/
53.4 ± 11.4 (male)
1 (a) assessment of adherence and psychosomatic aspects;
(b) groups selected on basis of adherence to treatment: low adh – 131 ppl, high adh – 30 ppl
Soboleva et al. [28] 2012 Regional clinical hospital and ambulatory care facility Patients with grades 1–3 of HT and cardiovascular disease. Recruitment process not described. Cross-sectional 242 18 y and older 1–3 (b) only possible to extract baseline data
Oganov et al. [29] 2007 Patients attending 512 physicians in 20 cities Men or women with HT and/or IHD Cross-sectional 2496 18 y and older 1–3 (a) big sample size;
(b) no prospective stage
Olejnikov et al. [30] 2014 Not stated
The authors are affiliation at Penza State Medical University
Men or women older than 60, with grades 1–2 of HT.
Recruitment process not described
Cross-sectional 75 66.6 ± 4.7 1–2 (a) studying adherence in the elderly;
(b) non-standard way of MMAS-4 analyze, small sample size, only possible to extract baseline data
Smirnova et al. [31] 2012 Ambulatory care facility Patients aged 45–75, with grades 1–2 of HT. Recruitment process not described Randomized non-blinded controlled intervention study 60 Intervention group: 62 ± 9.4, control group: 63 ± 8.9 1–2 (a) complex intervention on adherence;
(b) small sample size, relatively short follow up period – 3 mth
Vologdina et al. [32] 2009 Not stated Men and women with IHD and grades 1–2 of HT. Recruitment process not described Randomized non-blinded controlled by closed envelope method 70 80.7 ± 2.7 (female)/
80.3 ± 2.5 (male)
1–2 (a) studying adherence in the elderly;
(b) small sample size, relatively short follow up period – 3 mth
Sviryaev et al. [33] 2006 Ambulatory care facility Men or women older than 18, with grades 1–2 of HT with irregular therapy Prospective observational intervention study 115 51.3 ± 9.6 1–2 (a) follow up period 6 mth;
(b) no control group, numerical indicators of adherence level aren’t presented in the publication
Morozov et al. [34] 2010 The authors are affiliation at Russian military medical Academy, St. Petersburg Patients with grades 1–2 of HT Cross-sectional 86 30–73 y (54 ± 4,8) 1–2 (b) only possible to extract baseline data, non-standard way of MMAS-4 analyze
Kotovskaya et al. [35] 2015 Patients attending 830 physicians in 113 cities Men or women older than 18, with uncontrolled HT taking ACE inhibitors or angiotensin receptor blockers Prospective observational intervention study 2435 59.3 ± 11.2 Uncontrolled HTb (a) big sample size, multicenter;
(b) MMAS modified with 2 additional questions, no control group, relatively short follow up period – 3 mth
Panov et al. [36] 2015 Federal Medical Research Center, St. Petersburg Patients with grades 1–2 of HT and IHD Prospective observational intervention study 60 57.65 ± 1.59 1–2 (a) follow up period - 12 mth;
(b) small sample size
Oschepkova et al. [37] 2004 Patients who visited outpatient department of the Russian Cardiology Scientific and Production Center Men and women aged 30–71, with grades 1–2 of HT, without MI, stroke, heart failure, heart arrhythmias. Recruitment process not described Randomized non-blinded controlled intervention study 30 54 ± 11 1–2 (a) home BP devices as a way to increase adherence;
(b) described as randomized but main group – 19 ppl, control group − 11, small sample size
Kontsevaya et al. [38, 39] 2015 Patients who visited Outpatient Cardiology Clinic Men or women with grades 1–3 of HT Cross-sectional 1419 61.94 ± 0.26 1–3 (a) big sample size, a large number of factors associated with adherence: sociodemographic, clinical, etc.;
(b) no prospective stage
Kopnina et al. [40] 2008 Not stated Patients with HT. Recruitment process not described Cross-sectional 30 51 ± 1.14 (female) 2 (b) small sample size, only women are included in the study
Sergeeva et al. [41] 2012 Patients of the cardiological and endocrinological department of the Regional Clinical Hospital Men and women with HT or HT + DM.
Recruitment process not described
Cross-sectional 190 With HT:
47.6 ± 0.4,
with HT + DM:
44.7 ± 0.2
1–3 (a) association of adherence with hypertensive crisis was shown;
(b) no data on validation of bespoke questionnaire
  1. ACE inhibitors, angiotensin converting enzyme inhibitors, CVD cardiovascular diseases, DBP diastolic blood pressure, DM diabetes mellitus, HT arterial hypertension, IHD ischemic heart disease, MAS Medicine Assistance Scheme, MI myocardial infarction, MMAS-4 4-item Morisky Medication Adherence Scale, mth months, ppl people, SBP systolic blood pressure
  2. a Definitions of office blood pressure levels (mmHg): grade 1 hypertension: 140–159 and/or 90–99; grade 2 hypertension: 160–179 and/or 100–109; grade 3 hypertension: ≥180 and/or ≥ 110
  3. b Uncontrolled HT was defined with patients not taking a previously prescribed therapy, registered in the medical records or insufficiently effective therapy