COMPLIANCE WITH PRESCRIBED DIETARY REGIMEN AMONG HYPERTENSIVE OUT-PATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, OYO STATE

Abstract

Hypertension among patients could be well managed if patients comply with the prescribed dietary regimen. Noncompliance with prescribed dietary regimen is one of the major causes for poor control of hypertension among hospital clients. Not much work has been done on compliance to prescribed dietary regimen among hypertensive patients in tertiary health facilities. This study was therefore designed to assess hypertensive out-patients’ compliance with prescribed dietary regimen and associated factors at the University College Hospital, Ibadan. A cross-sectional study was conducted among 300 selected hypertensive outpatients. A pre-tested interviewer-administered semi-structured questionnaire which contained a 45-point knowledge scale, 24-points dietary intake pattern’s scale and 30 points food frequency scale was used to obtain information on respondents’ sociodemographic characteristics, hypertensive diet(nutritional) knowledge,compliance to prescribed dietary intake, food frequency of hypertensive patient, factors influencing compliance to dietary regimen and the observational features observed. Knowledge scores of 0 – 30, ˃31 ≤ 38 and ≥39 were classified as poor, average, and good respectively. Dietary intake pattern scores of 0 – 12, ˃13 ≤ 17 and ≥ 18 were categorised as poor, fair and good dietary intake patterns respectively and food frequency scores < 17, ˃18 ≤ 23 and ≥24 were categorised as poor, average and good food frequency respectively. Descriptive statistics and Chi-square test were used to analyse the data with level of significance set at 0.05. Mean age of respondents was 55.88 ± 16.24years, 52.3% were females and 82.0% were married. More than (50%) of the respondents were aged between 41 years and above when first diagnosed of hypertension. Majority (85%) of them have been receiving treatment for hypertension in the hospital for the past 6years. Only 12% of the respondents have good nutritional knowledge while almost two thirds, (60%) have average nutritional knowledge. Some of the factors deduced to be influencing the nutritional knowledge of the hypertensive patients include age (X2=26.067, p=0.0001), age when first diagnosed of hypertension (X2=25.345, p=0.0001), sex (X2=10.225, p=0.006) and occupation (X2=27.076, p=0.001). More than half (53.7%) of the respondents have partial compliance level to their dietary regimen. A major

reported barrier to compliance with prescribed dietary intake was difficulty in sticking only to the prescribed diet (52.3%). The dietary food intake frequency showed appreciable intake of some of the prescribed food between 4-7times in a week: fruits (78%.3) and vegetable (79.7%). Consumption of fried food, ‘chin chin’ and biscuits was shown not to improve weight loss, blood pressure and lipid profile. Vegetable improves blood pressure while carbonated drinks improve the lipid profile. The respondents’ knowledge on hypertensive diet was average which has a direct effect on their dietary intake pattern and their food frequency. Difficulty in sticking to only the recommended diet was found to be the main factor influencing noncompliance to their dietary regimen. Therefore, there is need for training programmes for dieticians and all health workers involved in dietary modification to always consider the availability, affordability and suitability of diet before prescription of diet to the patients.