Cognitive Behavioral Therapy Techniques to Improve Adherence to Therapy in Patients with Hypertension

Relevance . Cardiovascular diseases are currently among the leading causes of mortality in the Russian Federation. They result in physiological and biochemical changes in the body and thereby negatively affect an individual’s overall psychological state and subjective representation of illness. According to the Healthcare in Russia 2024 report published by the Federal State Statistics Service (Rosstat), the incidence of diseases of the circulatory system in the Russian Federation increased by 1.9 % over the two-year period from 2022 to 2023. Intention . To evaluate the effectiveness of cognitive-behavioral therapy (CBT) techniques to increase adherence to therapy in patients with hypertension in inpatient settings. Materials and methods . The effectiveness of CBT techniques for improving treatment adherence in hospitalized patients with hypertension was evaluated at a private healthcare institution, the Medical and Sanitary Unit, in Astrakhan, Russia. Data from 418 patients with hypertension (215 women and 203 men; mean age, 45 ± 7.4 years) were analyzed. All patients were examined and assessed in the cardiology department while undergoing inpatient treatment and receiving ongoing medical supervision from cardiologists and internists. Psychological characteristics and psychoemotional status were assessed using a battery of psychodiagnostic instruments: (1) the COP-25 Questionnaire for Quantitative Assessment of Treatment Adherence (N.A. Nikolaev and Yu.P. Skirdenko); (2) T. Leary’s Interpersonal Relations Test (Russian adaptation by L.N. Sobchik); (3) the Spielberger State-Trait Anxiety Inventory (Russian adaptation by Yu.L. Khanin); (4) the Big Five Personality Questionnaire (Russian adaptation by A.B. Khromov); (5) the Behavioral Self-Regulation Style Questionnaire (V.I. Morosanova); and (6) the Type of Attitude Toward Illness Questionnaire (TOBOL). Statistical analysis included Pearson’s linear correlation coefficient, Spearman’s rank correlation analysis, and Student’s t-test, performed using SPSS Statistics 28.0. Results and analysis . Given the limited time available during inpatient treatment, the use of brief psychotherapeutic approaches is particularly important for patients with hypertension. The study revealed a low overall level of treatment adherence among patients with hypertension, indicating limited engagement in following physicians’ recommendations regarding medication use, dietary adherence, and other lifestyle modifications. To improve treatment adherence in patients with hypertension, psychotherapeutic approaches, including cognitive behavioral therapy and motivational interviewing, are recommended. CBT is currently considered one of the most effective psychotherapeutic approaches for the treatment of psychosomatic disorders. Following the implementation of CBT techniques within a psychological intervention program aimed at improving treatment adherence, patients with hypertension demonstrated greater compliance with physicians’ recommendations, increased responsibility for their recovery, and improved quality of life. The improvement in health during inpatient treatment was also identified as a factor potentially contributing to increased treatment adherence and improvement in other psychological indicators. Conclusion . Cognitive behavioral therapy has several advantages, including the potential to produce psychotherapeutic effects within a relatively short period. In patients with cardiovascular disorders, the ultimate goals of psychological intervention include minimizing psychosocial risk factors associated with disease progression, promoting a more adaptive and harmonious subjective representation of illness, and improving quality of life. In addition, psychological rehabilitation interventions may facilitate therapeutic alliance and treatment adherence and help modify maladaptive beliefs and perceptions regarding the patient’s health condition.