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
The purpose of the study was to determine the influence of various factors on the level of adherence to treatment in patients with chronic obstructive pulmonary disease. Materials and methods. We examined 75 people with chronic obstructive pulmonary disease aged 45 to 65 years. In the study we used clinical examination of patients, laboratory, instrumental research methods, analysis of medical records, statistical-analytical, as well as clinical-psychopathological and psychodiagnostic methods (Morisky Medication Adherence Scale, determination of the level of subjective control, anxiety with Spielberger-Khanin method, the level of depression in the Beck questionnaire). Results and discussion. According to the results of the testing, three groups of patients were identified: 24% of patients with high, 32% of medium and 44% of low adherence to the treatment. Comparing our results with the literature, we can confirm data on a relatively low level of adherence to treatment among patients with chronic diseases, in particular chronic obstructive pulmonary disease. According to anamnestic data, patients with a high level of adherence to treatment were mostly married (61.11%) and had higher education (50%). Clinically, they belonged to group C (50%) with severe III airway obstruction (50%). These patients expressed high satisfaction with the inhaler (61.11%) and regularly communicated with the doctor (72.22%) (p <0.05). Regular communication of the patient with the doctor and satisfaction with their inhaler has an extremely significant impact on the level of adherence to treatment. According to a psychological study, these patients had an external type of subjective control (66.67%), a high level of personal anxiety (50%) and a pronounced level of depression (38.89%) (p <0.05). Numerous scientific studies on the impact of patients' commitment to the treatment of psychological factors, especially the level of personal anxiety and depression, contain a wide variety of data, which may indicate the extremely complex nature of each individual. Patients with a low level of adherence to treatment had difficulty using an inhaler (60.61%) and insufficient communication with a physician (69.70%) (p <0.05). In addition, according to psychological research, they had an internal type of subjective control (57.58%), low levels of personal anxiety (42.42%), severe (45.46%) and moderate levels of depression (42.42%) (р <0.05). Conclusion. Thus, the level of adherence to treatment in the examined patients with chronic obstructive pulmonary disease is low. This is influenced by a large number of socio-demographic, clinical-anamnestic and psychological factors
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