Estimation of the Compliance Level of Middle Age Patients with Arterial Hypertension

Abstract

Non-compliance to treatment recommendations of patients with chronic diseases is a global medical problem that significantly affects the effectiveness of treatment, leading to serious medical and economic consequences. Sufficient research on the problem of non-compliance with medical recommendations has led to the creation of a holistic concept of medical compliance. The purpose of the work was to estimate the main factors influencing the compliance to antihypertensive therapy of middle age patients with Arterial hypertension. Material and methods. We investigated 40 patients 50-60 years old (mean age 56.6±4.5 years) with Essential Arterial hypertension. Socio-demographic, clinical, pathopsychological, psycho-diagnostic methods (Morisky Medication Adherence Scale, self-assessment anxiety scale Charles D. Spielberger – Y. L Hanin, the Scale of Internality in relation to health and illness, the study of the self-esteem of mental states by H. J. Eysenck, the study of the level of depression by the Beck Depression Inventory), mathematical and statistical methods were used. Results and discussion. With the Morisky Medication Adherence Scale survey, we distinguished three groups of patients: with high (22.5%), middle (27.5%) and low (50.0%) levels of adherence to the combined therapy of hypertension. Socio-demographic factors in patients with low adherence to treatment were determined by lower level of education and absence of continuous marital relations. Clinical characteristics of patients with low compliance level included the presence of 3rd degree of severity, I stage of the Arterial hypertension, often comorbidities (Diabetes Mellitus 2nd type, Chronic Obstructive Pulmonary Disease, Ischemic Heart disease), long tobacco smoking. According to the psychopathological and psycho-diagnostic examination, patients with an internal type of personality control, low anxiety and depression mostly showed the low level of compliance and also more frequent aggressiveness in the self-esteem of mental states (p <0.05). Conclusion. Thus, patients of middle age with Essential arterial hypertension very often (up to 78%) showed the insufficient level of adherence to antihypertensive treatment. Socio-demographic, clinical and psychopathological factors significantly affect the level of compliance in these patients. Improving the effectiveness of therapy of Arterial hypertension in such patients is possible due to optimization of treatment regimens, wide introduction of psycho-diagnosis and psycho-correction with the involvement of psychologists into this process