Influence of Clinical Anamnestic and Psychological Factors on Adherence to Treatment of Patients with Chronic Obstructive Pulmonary Disease
Authors:   Chernivtsi, Bukovinian State Medical University, Department of internal medicine, clinical pharmacology and occupations diseases. 90-G, Prospekt Nezaleznosti, apt. 4, Chernivtsi 58029, Ukraine, Shumko H. I. , Reva T. V. ,   Chernivtsi, Bukovinian State Medical University, Department of internal medicine, clinical pharmacology and occupations diseases. 90-G, Prospekt Nezaleznosti, apt. 4, Chernivtsi 58029, Ukraine, Shuper V. O. ,   Chernivtsi, Bukovinian State Medical University, Department of internal medicine, clinical pharmacology and occupations diseases. 90-G, Prospekt Nezaleznosti, apt. 4, Chernivtsi 58029, Ukraine, Shumko M. I. ,   Chernivtsi Regional Center for Emergency Care and Disaster Medicine. 8, Mussorgskoho Str. , Chernivtsi 58018, Ukraine, Polataichuk V. P. ,   Chernivtsi Regional Hospital for War Veterans.20, Fastivska Str., Chernivtsi 58000, Ukraine
Published: December 2021

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