The influence of the psychoemotional state on the adherence to treatment of outpatient patients with hypertension

Objective: to assess the relationship between treatment adherence and psychoemotional status (PES) in outpatients with hypertension (AH).

Materials and methods: 114 outpatients of both sexes with AH were examined, median age 64.00 (57.00–73.00) years. Respondents completed an online quantitative assessment of adherence to treatment (KOП-25) questionnaire with the automatic calculation of 4 adherence indicators to lifestyle modification (LSM), to medical support (MS), to drug therapy (DT), total adherence to treatment (TAT). Adherence was assessed as low at < 50%, middle 50–75%, and high >75%. To diagnose the patient's PES, the questionnaire “Hospital Scale of Anxiety and Depression (HADS)”, the method of assessing anxiety of C.D. Spielberger, Y.L. Khanin.

Results: in patients with AH, the indicators of adherence to LSM, MS, DT, TAT 64,06±17,36; 73,00 (63,25–80,00); 69,53±16,12; 68,55±15,86%, respectively. Low adherence to LSM (in 21.9%) and high adherence to DT (in 40.4% of patients) were more common. On the HADS scale, 86.8/71.1% had no anxiety/depression, 8.8/19.3% had subclinical levels, and 4.4/9.6% had clinically significant levels, respectively. Reactive anxiety (RA) of low level was diagnosed in 36.8%, moderate in 48.2% and pronounced in 14.9%. In the absence of anxiety, lower adherence to LSM and MS was detected in 16.2% and 6.1%, with subclinical anxiety in 80% and 30% of patients, respectively. When analyzing the dependence of adherence to LSM, MS, DT and TAT on the presence/absence of depression in patients with AH, no significant differences were found. With an increase in RA, the number of patients with a low level of adherence increased and the number of patients with a high level of adherence to LSM, MS, DT and TAT decreased. More than half of patients with low RA experienced a high level of adherence to MS, DT, and TAT.

Conclusion: the majority of ambulatory patients with AH had an average level of virility to LSM, MS, DT, TAT. Low adherence to LSM and high adherence to DT were more common. Subclinical/clinical anxiety and depression were reported in 13.2% and 28.9% of ambulatory patients with AH, respectively. Almost 2/3 of patients with AH had moderate and high RA, indicating a stay in a stressful situation. Lack of anxiety in patients with AH was statistically significantly associated with increased adherence to LSM and MS, but was not associated with adherence to DT and TAT.

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