Factors Associated With Adherence To Dietary-Lifestyle Recommendations Among Hypertensive Patients Aged 18 Years And Above Attending Lira Regional Referral Hospital, Northern Uganda

Abstract

Introduction: Hypertension has become one of the world’s leading causes of mortality affecting about one billion people worldwide and killing over 9 million people every year. In Uganda, it is highly endemic with a prevalence of 28.4%. Objectives: This study assessed the factors associated with adherence to dietary and lifestyle recommendations among hypertensive patients aged 18 years and above in Lira Regional Referral Hospital. Specifically, it determined the level of adherence to the dietary and lifestyle recommendations and its associated patient/ healthcare/ diet and community related factors. Methods: A total of 384 hypertensive patients were randomly selected from the hypertensive clinic in the hospital and 5 health care providers from the same clinic were also included as key informants in the cross sectional study. Data was collected through face to face interviews and taking measurements of blood pressure, body weights and heights of the patients. Data collection tools included a structured questionnaire with a food frequency module and a key informant guide for health workers. Data were analysed using STATA 12. A total of 5 food groups (salt, fruits, vegetables, oils / fats and dairy products) and 3 lifestyle practices (physical activity, smoking and alcohol intake) were scored 1 point for adherence and 0 for non-adherence. Adherence was classified as good for total scores of at least 6 points and poor for scores below 6 points. The proportion of good adherence was obtained by dividing number of subjects with good adherence by number of subjects interviewed and multiplying by 100%. Multivariate logistic regression was used to identify the independent predictors of adherence. Results: Overall, only 34.1% of the participants had good adherence to the recommendations. Fruit (19.5%) and vegetable (36.7%) intakes had the lowest adherence levels observed while use of vegetable oil (89.6%), low sodium intake (92.7%), cessation of smoking (99%) and low alcohol consumption (99.2%)had the highest level of adherence observed. Good dietary knowledge and secondary level of education influenced adherence positively while presence of other Non-Communicable Diseases and lack of social support groups influenced it negatively. Conclusion: The study found low adherence to dietary and lifestyle recommendations among the study participants who were also overwhelmed with the challenge of poor dietary and lifestyle knowledge for their condition. Therefore, the government needs to: promote and support integration of nutrition education and counselling on NCDs into routine care services and also encourage the formation of social support groups to so as to help improve patients’ adherence.