The Effectiveness of Patient-Oriented Correction of Adherence to Treatment in Patients with Arterial Hypertension and Comorbid Chronic Obstructive Pulmonary Disease

Introduction. For today, the treatment of patients with comorbid pathology arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) remains insufficiently effective. The reason for this may be not only mutually aggravating course of these diseases, but also violations of adherence to antihypertensive and bronchodi-lator therapy in this category of patients. Aim. To determine the effectiveness of patient – oriented correction of adherence to treatment in patients with comorbid pathology arterial hypertension and chronic obstructive pulmonary disease after determining and elimi­nating the main causes of violations of adherence to antihypertensive (AHT) and bronchodilator treatment (BDT). Materials and methods. 94 patients with the established diagnosis of stage II hypertension and COPD of the 2nd or 3rd clinical groups (groups B and C) were examined, divided into two groups: the main group – 51 patients (54.3 %) with hypertension and concomitant COPD and comparison group – 43 patients (45.7 %) with essential hypertension. The data were analyzed by office and home blood pressure monitoring, spirometry parameters, the results of the questionnaires mMRS (modified Medical Research Council), CAT (COPD Assessment Test) and D. E. Morisky – L. W. Green's commitment to the treatment. Results. It was found that in patients with AH and concomitant COPD, in addition to the significant reduction in overall adherence to treatment, low attachment to bronchodilator therapy is more often than antihypertensive: 84.3 ± 5.1 % and 64.7 ± 6.7 % respectively (p < 0.02). Conducting the patient-oriented correction of adherence to treat­ment leads to significantly better control of blood pressure in patients with hypertension associated with COPD – in 73.1 ± 6.9 % of COPD patients in clinical group B and only in 57.6 ± 5.3 % of patients with clinical group C (p < 0,02) and improves the function of external respiration, including FEVj/FVC at 9.4 ± 4.1 % (p < 0,05). Conclusions. In patients with comorbid pathology of AH and COPD, in addition to the significant reduction in overall adherence to treatment, low bronchodilator tolerance is significantly more common than antihypertensive therapy. Conducting the patient-oriented correction of adherence to treatment leads to significantly better control of blood pressure in patients with hypertension associated with COPD and improves the function of external respiration.