Frequency and Predictors of Non-compliance to Dietary Recommendations Among Hypertensive Patients

Abstract

Compliance to dietary recommendations among hypertensive people is a major health care issue. Non-compliance can nullify the effects of even the most scientific and optimum treatment plan. The main aim of this study was to determine the frequency and predictors of non-adherence in our region. We also investigated the possible factors based on patient opinions that could increase compliance. A sample of 400 adult patients, diagnosed with hypertension for at least 3 years, who visited Civil Hospital during the time period April-June 2013 were included in this cross sectional study. Patient data and opinions were collected by two trained interviewers using a pre-coded questionnaire. Compliance was assessed based on patients self report. More than three quarters (n = 310, 77.5%) of the hypertensive patients were non-compliant. More than one social gathering in a week, peer-influence, no friends to follow the recommended diet plan and lack of believe regarding diet as an effective measure to control blood pressure were found to be the significant predictors of non-compliance (P values <0.0001). Counseling was thought to be the most effective way by the patients to increase adherence. Non-compliance to dietary recommendations is a major problem prevalent especially in Pakistan. There is an urgent need for doctors and nurses to counsel their patients effectively to prevent future morbidities and mortalities because of non-compliance.

Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension

“…We found that approximately 30% individuals managed their diet, but the prevalence of diet management was not different between adults with and without hypertension, and dietary adherence score was much lower in those with hypertension than in those without. Such a low dietary adherence has been reported in previous studies; hypertensive patients showed the best adherence to medication, followed by lifestyle modifications such as drinking and physical activity, and was the poorest for diet [14,[20][21][22]. In particular, hypertensive patients taking BP-lowering drugs had much unhealthier lifestyles than those who were not taking medications [14,23].…”

“…In general, the consequence of not taking medication is relatively instant and distinct, whereas the impact of not modifying lifestyle appears to be less immediate and much smaller. For this reason, some people may have no expectation for nonpharmacological treatment [14] or may not feel the need for adopting a healthy lifestyle [20]. There also seems to be the incorrect belief that that a powerful drug can sufficiently address the harmful effects of unhealthy habits due to a lack of understanding regarding the mechanisms of BP regulation [25].…”

“…However, among those diagnosed with hypertension, the practice rate of lifestyle modification was much lower. Previous studies have focused on patients with hypertension and/or cardiometabolic diseases [11,14,16,20], thus little is known about the differences between healthy and diseased individuals. It is difficult to explain directly why fewer hypertensive adults followed lifestyle modification guidelines than normotensive individuals.…”

Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community‐based management of non‐communicable diseases project in Nepal (COBIN)

“…Lifestyle advice given to promote lower salt intakes has had a positive effect on lowering salt consumption. Studies have reported the importance of a doctor or health worker's counseling on dietary salt control to lower blood pressure among hypertensive patients . Adherence to salt restriction is considered equally important as an antihypertensive drug .…”

“…Self-reported history of CVDs patients. [34][35][36][37][38] Adherence to salt restriction is considered equally important as an antihypertensive drug. 39 The findings of salt-related knowledge of this study are similar to the findings of the 2016 STEPS survey in Samoa.…”