Treatment compliance of patients with gastro-intestinal diseases

Aim of investigation. To study the effect of some social and psychological factors, disease-related factors, patient-related factors, and also to estimate the effect of psychopathological disorders on treatment compliance in patients with gastrointestinal diseases. Material and methods. Overall 151 patients (57 - with irritable bowel syndrome, 57 - with gastroesophageal reflux disease and 37 - with peptic ulcer of the stomach and duodenum) were investigated by structured interview method applying «the basic questionnaire for clinical and epidemiologic ethnocultural studies». Compliance was estimated by the universal validated Morisky medication adherence scale; the degree of treatment compliance was specified with the help of specially designed questionnaire. Results. At investigation of social and psychological factors it was revealed that most of noncompliant patients were employed (85,9%; p<0,05), of 40 to 49 years of age (25,6%; p<0,05), having secondary education (56,4%; p<0,05), possessing nonconstructive model of parent-child relationship (85,9%; p<0,05), as well as the patients from risk groups and those with interfamily conflicts (18,2% and 15,4%; 0% p<0,05). Analysis of disease-related and patient-related factors of compliance has revealed, that patients from risk groups and noncompliant patients had more frequent complaints (75% and 78,2%; 34,5%; p<0,001). They less commonly choose official healthcare as a preferred treatment method (63,6%, 75,6% less often; 100% p<0,01), they had lower degree of awareness of their disease and provided treatment (82,1%; p<0,05). Most of the risk group patients had chronic diseases that lasted for more than 2 years (95,5%; p<0,05 and p<0,01), these patients were hospitalized in different hospitals more commonly (77,3%; p<0,001). Risk group patients were much more frequently dissatisfied by amount of time spent to them by their doctor at admission than compliant patients (40,9%; p<0,05). Studied patients revealed quite frequent psychopathological disorders. Risk group patients and noncompliant patients had significantly higher rate of paranoid disorders (15,9%, 16,7%; 0% p<0,05), in the risk group patients anancastic disorder prevailed along with paranoid (45,5%). Conclusions. Family conflicts, nonconstructive model of parent-child relationship, employment, absence of higher education and age of 40 to 49 years were noncompliance predictors among social and psychological factors. Personality disorders, in particular paranoid and anancastic are accompanied by low treatment compliance. Patients with low compliance had high number of complaints, multiple admissions to different hospitals, changing of the attending physician because of diagnosis and treatment disagreements, disease duration of more than 2 years, insufficient knowledge of the disease and prescribed medications.

комплаентность, синдром раздраженного кишечника, гастроэзофагеальная рефлюксная болезнь, язвенная болезнь желудка и двенадцатиперстной кишки, психопатологические синдромы

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