Socio-demographic factors of commitment to treatment in atrial fibrillation: a psychologist's view



The article provides an overview of foreign and national studies of socio-demographic factors of patients' commitment to treatment in atrial fibrillation and other chronic diseases. Low adherence to treatment with long-term therapy is the main reason for the decline in treatment effectiveness. Socio-demographic predictors of commitment to treatment, such as gender, age, race, marital status, education and income, are considered. Analysis of the results of studies shows the ambiguity and frequently contradictory connection of these factors with the commitment to treatment. At the same time, adherence to treatment is studied in connection with individual-personal factors - personality traits, level of emotional intelligence, self-efficacy, motivational features. It is suggested that individual-personal and general socio-demographic factors interact and have an indirect effect on adherence to treatment in long-term therapy.

General Information

Keywords: commitment to treatment, socio-demographic factors, individual-personality predictors, individual differences, atrial fibrillation

Journal rubric: Medical Psychology

Article type: review article


Funding. The reported study was funded by RFBR according to the research project № 18-00-01661 (18-00-01326)

For citation: Shepeleva E.A., Lapteva N.M., Mukhorina A.K., Bogdanova R.S., Syrkina E.A. Socio-demographic factors of commitment to treatment in atrial fibrillation: a psychologist's view [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2019. Vol. 8, no. 3, pp. 78–87. DOI: 10.17759/jmfp.2019080309. (In Russ., аbstr. in Engl.)


  1. Kachkovskii M., Krasnoslobodskaya O. Priverzhennost' medikamentoznoi terapii bol'nykh s fibrillyatsiei predserdii [Elektronnyi resurs] [Adherence to drug therapy in patients with atrial fibrillation]. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Meditsina [Bulletin of the russian university of people's friendship. series: medicine], 2010, no. 4, pp. 229–233. URL: (Accesed 13.09.2019). (In Russ.; Abstr. in Engl.).
  2. Korobeinikova A.N., Mal'chikova S.V. Izuchenie priverzhennosti lecheniyu patsientov s fibrillyatsiei predserdii v ambulatornoi praktike [The study of adherence to treatment of patients with atrial fibrillation in outpatient practice]. Lechashchii vrach [Therapist], 2017, no. 2, pp. 16–20. (In Russ.).
  3. Lyubaeva E.V., Enikolopov S.N. Rol' individual'nykh psikhologicheskikh kharakteristik patsientov v formirovanii priverzhennosti terapii tuberkuleza i VICh [Elektronnyi resurs] [The role of individual psychological characteristics of patients in developing of adherence to tuberculosis and hiv therapy]. Konsul'tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2011, no. 2, pp. 111–127. URL: (Accessed 13.09.2019). (In Russ.).
  4. Mark B. The Merck Manual. Rukovodstvo po meditsine. Diagnostika i lechenie [The Merck Manual. Guide to medicine. Diagnosis and treatment]. Moskva: Litterra, 2011. 3698 p. (In Russ.).
  5. Machil'skaya O.V. Faktory, opredelyayushchie priverzhennost' k lecheniyu bol'nykh arterial'noi gipertenziei (obzor literatury) [Factors determining adherence to treatment of patients with arterial hypertension (literature review)]. Kardiologiya i serdechno-sosudistaya khirurgiya [Cardiology and Cardiovascular Surgery], 2016, no. 3, pp. 55–65. doi:10.17116/kardio20169355-65. (In Russ.).
  6. Semenova O.N., Naumova E.A. Faktory, vliyayushchie na priverzhennost' k terapii: parametry VOZ i mnenie patsientov kardiologicheskogo otdeleniya [Factors affecting adherence to therapy: WHO parameters and opinion of patients in the cardiology department]. Byulleten' meditsinskikh Internet-konferentsii [Online Medical Conference Bulletin], 2013, vol. 3, no. 3, pp. 507–511. (In Russ.).
  7. Sirota N.A., Moskovchenko D.V., Yaltonskaya A.V. Sovladayushchee povedenie zhenshchin s onkologicheskimi zabolevaniyami reproduktivnoi sistemy [Elektronnyi resurs] [The coping behavior of women with cancer of the reproductive system]. Meditsinskaya psikhologiya v Rossii: elektronnyi nauchnyi zhurnal [Medical Psychology in Russia: an electronic scientific journal], 2014, vol. 1, no. 24, 10 pp. URL: (Accessed 27.03.2019). (In Russ.).
  8. Khokhlov A.L., Lisenkova L.A., Rakov A.A. Analiz faktorov, opredelyayushchikh priverzhennost' k anti-gipertenzivnoi terapii [Elektronnyi resurs] [Analysis of factors determining adherence to anti-hypertensive therapy]. Kachestvennaya klinicheskaya praktika [Good clinical practice], 2003, no. 4, pp. 59–66. URL: (Accessed 27.03.2019).
  9. Mills E. et al. Adherence to HAART: a systematic review of developed and developing nation patient reported barriers and facilitators [Elektronnyi resurs]. PLoS Med, 2006, vol. 3, no. 11, 438 p. URL: (Accessed 27.03.2019).
  10. Abdou J.K. et al. Adherence to long-term anticoagulation treatment, what is known and what the future might hold. British Journal of Haematology, 2016, vol. 174, no. 1, pp. 30–42. doi:10.1111/bjh.14134
  11. Obamiro K.O. et al. Adherence to Oral Anticoagulants in Atrial Fibrillation: An Australian Survey. Journal of Cardiovascular Pharmacology and Therapeutics, 2018, vol. 23, no. 4, pp. 337–343. doi:10.1177/1074248418770201
  12. Baroletti S., Dell’Orfano H. Medication adherence in cardiovascular disease. Circulation, 2010, vol. 121. 1455–1458. doi:10.1161/CIRCULATIONAHA.109.904003.
  13. Booth-Kewley S., Vickers RR Jr. Associations between major domains of personality and health behavior. Journal of Personality, 1994, no. 62, pp. 281–298. doi:10.4236/psych.2012.38083
  14. Costa P.T., McCrae R.R. Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) professional manual. Odessa, FL: Psychological Assessment Resources, 1992. 101 p.
  15. MacEdo A.F. et al. Determinants of oral anticoagulation control in new warfarin patients: analysis using data from clinical practice research datalink. Thrombosis Research, 2015, vol. 136, no. 2, pp. 250–260. doi:10.1016/j.thromres.2015.06.007
  16. DiMatteo M. Social Support and Patient Adherence to Medical Treatment: A Meta-Analysis. Health Psychology, 2004, vol. 23, no. 2, pp. 207–218. doi:10.1037/0278-6133.23.2.207
  17. Edmonds G.E., Bogg T., Roberts B.W. Are personality and behavioral measures of impulse control convergent or distinct predictors of health behaviors? Journal of Research in Personality, 2009, vol. 43, no. 5, pp. 806–814. doi:10.1016/j.jrp.2009.06.006
  18. Inse K. et al. Executive Function, Working Memory, and Medication Adherence Among Older Adults. The journals of gerontology. Series B, Psychological sciences and social sciences, 2006, vol. 61, no. 2, pp. 102–107. doi:10.1093/geronb/61.2.P102
  19. Tsiantou V. et al. Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study. Patient preference and adherence, 2010, vol. 4, pp. 335–343. doi:10.2147/PPA.S12326.
  20. Frishman W.H. Importance of medication adherence in cardiovascular disease and the value of once-daily treatment regimens. Cardiology in review, 2007, vol. 15, no. 5, pp. 257–263. doi:10.1097/CRD.0b013e3180cabbe7
  21. Grant A.B., Williams N.J., Pandi-Perumal S.R. Nonadherence to antihypertensive. Journal of Clinical Hypertension, 2017, vol. 19, no. 5, pp. 540–542. doi:10.1111/jch.12990
  22. Iloh G. Family Functionality, Medication Adherence and Blood Glucose Control Among Ambulatory Type 2 Diabetic Patients in a Nigerian Hospital [Elektronnyi resurs]. Journal of Basic and Clinical Pharmacy, 2017, vol. 8, no. 3, pp. 149–153. URL: (Accessed 27.03.2019).
  23. Ferdinand K.C. et al. Improving Medication Adherence in Cardiometabolic Disease: Practical and Regulatory Implications. Journal of the American College of Cardiology, 2017, vol. 69, no. 4, pp. 437–451. doi:10.1016/j.jacc.2016.11.034
  24. Krueger K.P., Felkey B.G., Berger B.A. The Pharmacist’s Role in Treatment Adherence. Part 4: Do Adherence Interventions Really Have An Impact? US Pharmacist, 2005, vol. 5, pp. 62–66.
  25. Marcum Z.A., Hanlon J.T., Murray M.D. Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials. Drugs & Aging, 2017, vol. 34, no. 3, pp. 191–201. doi:10.1007/s40266-016-0433-7
  26. Simoni J. et al. Mediators of social support and antiretroviral adherence among an indigent population in New York City. AIDS Patient Care STDS, 2002, vol. 16, no. 9, pp. 431–439. doi:10.1089/108729102760330272
  27. Dunbar-Jacob J. et al. Medication adherence in persons with cardiovascular disease. The Journal of cardiovascular nursing, 2003, vol. 18, no. 3, pp. 209–218. doi:10.1097/00005082-200307000-00006
  28. Glazer N.L. et al. Newly detected atrial fibrillation and compliance with antithrombotic guidelines. Archives of internal medicine, 2007, vol. 167, no. 3, pp. 246–252. doi:10.1001/archinte.167.3.246
  29. Tong X. et al. Nonadherence to Antihypertensive Medication Among Hypertensive Adults in the United States – HealthStyles. Journal of clinical hypertension, 2016, vol. 18, no. 9. doi:10.1111/jch.12786.
  30. Grant R.W. et al. Polypharmacy and Medication Adherence in Patients With Type 2 Diabetes. Diabetes Care, 2003, vol. 26, no. 5, pp. 1408–1412. doi:10.2337/diacare.26.5.1408
  31. Gumbinger C. et al. Reasons underlying non-adherence to and discontinuation of anticoagulation in secondary stroke prevention among patients with atrial fibrillation. European neurology, 2015, vol. 73, no. 3–4, pp. 184–91. doi:10.1159/000371574
  32. Reading S.R. et al. Risk factors for medication non-adherence among atrial fibrillation patients. Cardiovascular Disorders, 2019, vol. 19, no. 1, pp. 1–12. doi:10.1186/s12872-019-1019-1
  33. Platt A.B. et al. Risk factors for nonadherence to warfarin: results from the IN-RANGE study. Pharmacoepidemiology and drug safety, 2008, vol. 17, no. 9, pp. 853–860. doi:10.1002/pds.1556
  34. Axelsson M. et al. Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life. Quality of Life Research, 2012, vol. 22, no. 3, pp. 567–575. doi:10.1007/s11136-012-0181-z
  35. Chase J.A.D. et al. The Effectiveness of Medication Adherence Interventions Among Patients With Coronary Artery Disease. The Journal of Cardiovascular Nursing, 2016, vol. 31, no. 4, pp. 357–366. doi:10.1097/jcn.0000000000000259
  36. Axelsson M. et al. The Influence of Personality Traits on Reported Adherence to Medication in Individuals with Chronic Disease: An Epidemiological Study in West Sweden. PLoS One, 2011, vol. 6, no. 3, 7 p. doi:10.1371/journal.pone.0018241
  37. Umaki T.M. et al. The psychology of patient compliance: a focused review of the literature. Journal of Periodontology, 2012, vol. 83, no. 4, pp. 395–400. doi:10.1902/jop.2011.110344
  38. Wiebe J.S., Christensen A.J. Patient Adherence in Chronic Illness: Personality and Coping In Context. Journal of Personality, 1996, vol. 64, no. 4, pp. 815–835. doi:10.1111/j.1467-6494.1996.tb00945.x
  39. World Health Organization. Adherence to long-term therapies: evidence for action [Elektronnyi resurs]. Geneva: World Health Organization. 2003. 209 p. URL: (Accessed 28.03.2019).
  40. Wyndham C. Atrial Fibrillation: The Most Common Arrhythmia [Elektronnyi resurs]. Texas Heart Institute Journal, 2000, vol. 27, no. 3, pp. 257—267. URL: (Accessed 28.03.2019).

Information About the Authors

Elena A. Shepeleva, PhD in Psychology, Senior Research Fellow of the Sector "Center for Cognitive Research of the Digital Educational Environment" CIRCC, Moscow State University of Psychology and Education, Moscow, Russia, ORCID:, e-mail:

Nadezhda M. Lapteva, PhD in Psychology, Research Associate, the laboratory of Psychology and Psychophysiology of Creativity, Institute of Psychology of Russian Academy of Science, Research Associate, the laboratory for the Study of Cognitive and Communicative Processes in Adolescents and Young Adults while Solving Game and Educational Problems using Digital Environments, Moscow, Russia, ORCID:, e-mail:

Anna K. Mukhorina, PhD in Medicine, Assistant of the Department of Psychiatry and Psychosomatics, Federal State Autonomous Educational Institution of Higher Education THEM, Federal State Budgetary Institution Scientific Center for Psychic Health, Moscow, Russia, e-mail:

Radmila S. Bogdanova, Assistant of the Department of Cardiology, Functional and Ultrasound Diagnostics, Institute of Clinical Medicine, Sechenov Moscow State Medical University (Sechenov University), Moscow, Russia, e-mail:

Elena A. Syrkina, PhD in Medicine, Associate Professor of the Department of Cardiology, Functional and Ultrasound Diagnostics, Institute of Clinical Medicine, First Moscow State Medical University Named After I.M. Sechenov, Moscow, Russia, e-mail:



Total: 1042
Previous month: 8
Current month: 1


Total: 325
Previous month: 4
Current month: 1