Background It is known that one of the main demands of the health system is to improve preventive measures. In particular, issues of optimizing secondary prevention are very important, as it gives an opportunity to reduce the progression of the disease and complications, as well as improve the quality of life of patients. Therefore, the study values the correction of progesterone deficiency on the background of preventive and rehabilitation interventions in a general medical practice in patients with RA is of practical interest.
Objectives Studying the role of progesterone deficiency correction efficiency to optimize secondary prevention in patients with RA in a general medical practice.
Methods Study involved 180 RA patients aged 35,6±3,9 years. The study group (group 1) consisted of 80 patients with RA, the second 50 (group 2) and third and 50 (group 3). 1 group was carried preventive and curative interventions, based on an integrated approach with the inclusion of preventive and rehabilitation interventions on the background correction of progesterone deficiency (Duphaston) in a general medical practice. Group 2 is the same, but without the correction of progesterone deficiency, and the third group only took pathogenetic treatment. Group 3 as opposed to the 1 and 2 had displays of progesterone deficiency. For an objective assessment of the effectiveness of using EULAR recommendations, assessing the improvement in %, according to the ACR, and to assess the functional status - health status index questionnaire Stanford Health Assessment Questionnaire (HAQ)
Results The impact of interventions carried out by us on the functional outcome showed some differences between groups. Thus, according to ACR 50 criteria dynamics between groups were significant difference at 24 months, since improvement was noted in 52% of group 1 and 32% in group 2 (p=0.032).By the end of 3 months of intervention minimal effect on performance within the HAQ 0,22≤ ΔNAQ≤0,36 was observed in 80% of group 1, 78% in 2nd group and 76% in group 3 (p>0.05), while not a single case was fixed not satisfactory or pronounced effect. By the end of 12 months, the dynamics of functional status was noticeable and patients in group 1 have prevailed a satisfactory effect within 0,36≤ΔHAQ <0.80 - 48.75% (p=0.043 and p=0.048, respectively), so a marked effect within ΔHAQ≥0,80 functional status - 15% (p=0.001; p=0.011, respectively). This trend continued and by the end of 24 and 36 months, as the group 1 compared with group 2 is almost 8 times (p=0.001) and group 3 2 times (p. =0.045) greater ΔHAQ≥0,80 a marked effect.
Conclusions The preventive and therapeutic interventions on the background correction of progesterone deficiency in RA patients in a general practice reliably delivers stable ACR 50 response (64%) and significantly improves the functionality of the joints in RA.
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Disclosure of Interest None declared