Psychological Factors of Treatment Adherence in Patients with Essential Arterial Hypertension

Abstract

Introduction In Russian clinical tradition and psychological research of Vygotsky-Luria school much consideration is given to relationships between the doctor and the patient, regarding it as an efficiency factor of treatment and rehabilitation. Objectives To evaluate the concordance with treatment adherence and those psychological factors that affect the treatment compliance in patients with essential arterial hypertension (EAH). Methods A questionnaire-based study was undertaken with EAH patients attending public hospitals in Moscow, Russia. There were applied a Questionnaire for Interpersonal Relationships Assessment (Sobchik, 2005), Questionnaire for Assessment of Types of Attitudes Towards the Disease (Wasserman, 2005), Psychodiagnostic Interview for Treatment Adherence, Drug Attitude Inventory, and Multidimensional Scale of Perceived Social Support (Zimet et al., 1988). 170 EAH patients took part in the study, the mean age was 46.7±4.1 years, EAH duration was 7.2±2.6 years. Results It was found that 75.3% of the patients defied the doctor's prescriptions. Forgetfulness, lack of tendance, and negligence were ranked as the top three reasons for this non-compliance. A statistically significant relationship with non-compliance was found for anxious, melancholic and neurasthenic types of attitude towards the disease, as well as predominance of distrustfully-skeptical interaction style in a dyad 'doctor-patient' and the lack of social support, and such characteristics, as age and education level. Patients with high compliance have predominantly sensitive type of attitude towards the disease, high intensity of social support, and dependent-obedient style of interaction with doctor. Conclusions These results indicate the need to consider the psychological factors to improve treatment adherence in EAH patients.