Possibilities of a patient-centered approach for older age group of patients with cardiovascular comorbidity and obstructive sleep apnea syndrome


DOI: https://dx.doi.org/10.18565/therapy.2024.4.26-33

Verushkina A S., Efremova E.V., Shutov A.M., Serov V.A., Rebrovskaya M.M.

1) Saint Andrew the Apostle State Clinical Hospital, Ulyanovsk; 2) Ulyanovsk State University
Abstract. While aging, the number of chronic pathologies in patients increases, and cardiovascular comorbidity also is growing. For patients in the older age group, improving life quality (QL) and prognosis from the perspective of a patient-centered approach is especially actual.
The aim: to assess the quality of life of comorbid patients of an older age group with obstructive sleep apnea syndrome (OSA) using a patient-centered approach.
Material and methods. The sample included 102 patients (58 male and 44 female) of elderly and senile age with cardiovascular pathology. The average age of individuals was 66.7 ± 6.1 years. SF-36, EQ-5D-5L questionnaires (Russian, 2009 EuroQol Group), vertical visual analogue scale (VAS), hospital anxiety and depression scale (HADS), mini-mental state examination scale (MMSE) were used in the study. All patients underwent a standard general clinical examination and comorbidity assessment using modified Charlson comorbidity index (CI), including one adjusted for age. For OSA assessment, Berlin questionnaire, Epworth sleepiness scale, and cardiorespiratory monitoring were used. Observation of patients lasted 12 months, prognosis and quality of life were estimated.
Results. Estimation of life quality in older age group of patients with high comorbidity showed a decrease in life quality index comparatively to the initial one – 0.43 (0.26; 0.65) versus 0.50 (0.47; 0.84), p = 0.04. A decrease in this parameter was also observed in patients with OSA – 0.41 (0.24; 0.68) versus the initial value of 0.54 (0.44; 0.80), p = 0.035. The study group of patients is characterized by a low frequency of seeking medical help (only 10.8% of persons with a newly diagnosed OSA were consulted by somnologist).
Conclusion. For patients of the older age group having OSA with high comorbidity, it is important to use a patient-centered approach in order to improve prognosis and quality of life.
Keywords: patients of the older age group, cardiovascular comorbidity, patient-oriented approach, obstructive sleep apnea syndrome, quality of life
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About the Autors

Alexandra S. Verushkina, MD, chief physician of Saint Andrew the Apostle State Clinical Hospital. Address: 432072, Ulyanovsk, 4 Vracha Surova St.
E-mail: muz.gkb1omr@yandex.ru
ORCID: https://orcid.org/009-0004-8859-1462
Elena V. Efremova, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of therapy and occupational diseases, Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 L. Tolstogo St.
E-mail: lena_1953@mail.ru
ORCID: https://orcid.org/0000-0002-7579-4824
Alexander M. Shutov, MD, Dr. Sci. (Medicine), professor, head of the Department of therapy and occupational diseases, Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 L. Tolstoy St.
E-mail: amshu@mail.ru
ORCID: https://orcid.org/0000-0002-1213-8600-42
Valery A. Serov, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of therapy and occupational diseases, Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 L. Tolstoy St.
E-mail: valery_serov@mail.ru
ORCID: https://orcid.org/0000-0003-1815-5599
Maria M. Rebrovskaya, MD, assistant, postgraduate student of the Department of therapy and occupational diseases, Ulyanovsk State University. Address: 432017, Ulyanovsk, 42 L. Tolstoy St.
E-mail: rebrovskayamary@mail.ru
ORCID: https://orcid.org/009-0005-5166-758X


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