A pilot study on compliance with prescription drugs to prevent secondary incidents of cardiovascular diseases (CVD) among the semi-rural population of Ernakulam has shown poor adherence.
Doctors conducting the Epidemiology of Non-Communicable Diseases in Rural Areas (ENDIRA) with the support of the National Health Mission are now holding a one-year study after the pilot study of 306 individuals with chronic cardiovascular disease revealed that adherence to prescription drugs was at 5 on a scale of 8.
A scale of 6-7 is moderate, while 8 is good. CVD patients are, as a rule, given four drugs, and the study found that they took a mean of only 2.8 drugs. The pilot study was conducted in the panchayats of Mookanoor, Karukutty, Manjapra, Thuravoor, and Kalady.
Meanwhile, ENDIRA, which targets 2,000 patients, will also study the integration of e-health and mobile health platforms to create a learning health system for cardiovascular diseases (LHS-CVD).
According to Dr. Jaideep Menon, principal investigator of ENDIRA, the availability of a non-physician health worker like an Accredited Social Health Activist (ASHA) in the community, growth of mobile telephone technology, and improved IT capability of public health systems with e-health platforms offering opportunities for linking data from patients to healthcare settings can bring about adherence to drugs for quality life and create a learning health system in the public domain.
The study equips ASHAs to go into the community with a digital kit in a cloth bag that consists of a tablet PC, digital glucometer, digital weighing machine, digital BP apparatus, and a measuring tape.
There are 86 ASHAs in 75 wards of the five panchayats. They share a total of 40 devices among them to conduct the study.
A full medical history of the patient along with that of members of the household over 30 years of age gets recorded in the tablet.
The study is led by Dr. Amitava Banerjee, a cardiologist based at the University College of London.
The project is co-ordinated by the University of Central Lancashire, UK, and Research Information Systems for SAARC Countries under Union government and is funded through a grant from the European Union.
Other issues, including validity of outcomes, barriers to recruitment, follow-up, and data linkage are also part of the study.
Dr. Menon said it would be indicative of socio-economic issues, like the cost of drugs and availability and access to low-cost drugs.
