Purpose: To determine the effect of a computer system using text messages (SMS) for patient feedback on the control of blood pressure (BP) in patients with arterial hypertension (AH). Methods: 199 patients (≥ 18 years old) with established AH were enrolled in the study. 97 of them (mean age 49 ± 11.3 years) were offered to answer to automatically generated SMS requests about their BP level during 1 year. The other 102 patients (mean age 51 ± 11.1 years) received usual care. Their BP records concerning the same period were extracted from ambulatory patients’ cards retrospectively. Three control check points were assigned for the group of SMS monitoring - one, six and 12 months of follow up. The number of patients dropped out of SMS monitoring, and principal causes of withdrawal were determined on every checkpoint. A part of patients with goal BP was estimated over each period. Goal BP was defined according to ESH-ESC Hypertension Guidelines (2007). In a year of follow up, the rate of the goal BP achievement was compared in SMS monitoring group vs. the group of usual care. Results: 62 from 97 patients included in the group of SMS monitoring (64%) successfully completed one year of follow up. During the first month 15 patients (16%) had left the study. The principal cause in 9 patients (60%, p < 0.05) was “difficulties using text messaging”. During the period from one to six months of observation 19 more patients had withdrawn from SMS monitoring. The main cause in 15 participants (79%, p < 0.05) was “lost of interest”. Patients reported they felt well and were satisfied with treatment. During the period from six to 12 months only 1 patient had withdrawn (the cause – “lost of interest”). In the group of SMS monitoring goal BP was achieved in 84% of patients (CI 75% - 93%) after the first month of study, in 77% (CI 67% - 88%) after six months and in 71% (CI 60% - 83%) after 12 months. In the group of usual care goal BP was achieved in only 12% of patients (CI 5% – 18%). Odds ratio was 13 (CI 6.0-29.6). Conclusion: Use of computer system with patient feedback via text messages enhances achievement of goal BP in AH patients as compared with usual care, and facilitates its maintenance in primary care over a long time period.
Journal of Hypertension. 2011. Vol 29. e-Supplement A. P. e559

In the article the actual data about the state of curative and prophylactic medical care in railway medicine have been analyzed. unsolved issues are presented in the study. They concern with the organization and quality supply in prophylactic and rehabilitation work. these problems demand a necessity of further research in this area and development of scientific programs for optimization of curative and prophylactic measures
E.V. Molodtzova, G.N. Shemetova Actual and unsolved issues of curative and prophylactic care organisation in railway medicine // Saratov Journal of Medical Scientific Research, Vol. 6, Issue 1, 2010, pp. 88-94

The research results of volume and character of out-patient aid are presented in the article. The aid has been rendered to urban population in conditions of the Centre of General Medical Practice at Saratov Polyclinic №16. The information given in the article can be useful for the organization of the similar centre in other regions of the country.
G.N. Shemetova, M.E. Balashova, A.S. Ulyanova DEVELOPMENTAL EXPERIENCE OF GENERAL MEDICAL PRACTICE IN CONDITIONS OF MUNICIPAL HEALTH SERVICE // Saratov Journal of Medical Scientific Research, Vol. 5, Issue 1, 2009, pp. 87-89

The article is focused on stages of general medical practice formation in Russia (family medicine) as the basic componentof primary health care. Experience of introduction of general medical practice structure (family medicine) at regional level is shown and the role of Saratov State Medical University in specialists' training is submitted; unsolved problems are also examined.
P.V.GIybochko, A.A.Svistunov, G.N.Shemetova GENERAL MEDICAL PRACTICE: STAGES OF DEVELOPMENT AND ROLE OF SARATOV STATE MEDICAL UNIVERSITY IN ITS FORMATION AT REGIONAL LEVEL // Saratov Journal of Medical Scientific Research, Vol. 4, Issue 4, 2008, pp. 9-12

The necessity of improvement of medical care quality to patients with hypertension set conditions for the development of an alternative approach to evaluation of the effectiveness of medical care to such patients aimed to reveal deviations of medical care procedures from guidelines of National Recommendations on Hypertension. The most common statistical indices used currently and designated for the quality of care to patients with hypertension assessment are not founded on evidence-based data of Recommendations. Aim. To compare the results of estimation of quality indicators founded on evidence-based data on arterial hypertension presented in National Recommendations with the results of estimation of comparable statistical indices used commonly in clinical practice. Material and methods. The results of two-year management of 458 patients with hypertension of I-III grades aged 55±19 in four polyclinics of Saratov were studied. The main statistical and clinicodemographic characteristics of the hypertensive patients (the first method) and quality indicators developed (the second method) were estimated. Results. Under comparing the first and the second methods the following values of assessing characteristics were obtained. The percentage of patients with established arterial hypertension was 89.6% и 32.7% respectively. The percentage of patients with hypertension, who had one or more risk factors, was 42.3% и 67.8% respectively. The percentage of patients with the evidence of target organs damage or/and associated clinical condition was 48.2% и 59.9% respectively. The percentage of patients with secondary hypertension was 1.2% и 3% respectively. The percentage of patients in whom blood pressure (BP) achieved its target level was 26.2% и 9.4% respectively. The percentage of patients in whom a target BP level has been sustained was 2.1% и 1.7% respectively. Furthermore, the set of developed quality indicators included the following characteristics: assessment of personal 5-year risk of fatal cardiovascular events, BP level assessment before starting of medical treatment, registration of patients with hypertension who had one or more modified risk factors and received documented advice on lifestyle change measures at least once a year, assessment of medication principles compliance and regularity of hypertensive patients observation. At present, there are no analogues to such care quality characteristics among up-to-date statistical indices. Conclusions. 1. The results of cardiologic situation assessment obtained with the help of quality indicators differ substantially from the results obtained with the help of the main statistical characteristics. 2. Quality indicators of medical care have more applied value then the main currently used statistical characteristics because they are founded on evidence-based data of National Recommendations on Hypertension and point out directly those problems of the treatment-and-diagnostic process which need to be improved for raising the quality of medical care.
Abstract book of International Congress “Hypertension – from Korotkov to present days”, September 15-17, 2005, Saint-Petersburg, Russia: p 42-43