Obesity and Adherence to Treatment According to the Qaa-25 Questionnaire in a Prospective Follow-Up Study

Introduction. Obesity is a modifiable cardiometabolic risk factor and a comorbidity-associated disease. Hence, to improve the effectiveness of individual preventive programs, it is important to study the features of treatment adherence in young adults. Aim of the study was to analyze the changes in various types of obesity considering the adherence to treatment in young adults. Materials and Methods. This prospective study (Me=18.6[17.4-20.1] months) enrolled 94 (45 male (47.9%) and 49 female (52.1%)) patients aged Me=33[28.7-38] years. The presence of overweight, general and abdominal obesity, and excess visceral fat level was analyzed. Treatment adherence was assessed using the quantitative assessment of the adherence (QAA-25) questionnaire. Overall adherence to treatment, adherence to lifestyle modification, pharmacotherapy, and medical follow-up were determined. A level of ≤49% was considered low; 50-74% as medium, and ≥75% as high. IBM SPSS Statistics 26 was used for statistical analyses. Results and Discussion. We found an increasing trend in the incidence of abdominal obesity and excess visceral fat levels during follow-up. In the study cohort, majority had low adherence levels: overall adherence to treatment – 64.9%(n=61), adherence to lifestyle modification – 53.2(n=50), adherence to pharmacotherapy – 64.9%(n=61), and adherence to medical support – 47.9% (n=45). In all types of low adherence levels, there was an increase in the incidence of abdominal obesity due to increased waist circumference and waist-to-hip ratio. Likewise, the odds of higher excess visceral fat levels increased by 1.15-fold with low overall treatment adherence; 1.19-fold with low adherence to lifestyle modification and pharmacotherapy; and 1.49-fold in those with low adherence to medical support. The odds of becoming overweight and obese increased in those with low and medium adherence to lifestyle modification by 6.22 and 10.11 times, respectively. Conclusions. The adherence level according to the QAA-25 scores in young adults was low. During follow-up in all types of low adherence levels, the incidence of abdominal obesity and the odds of excess visceral fat level increased. During 18-month prospective follow-up, the cardiometabolic profile significantly worsened in patients with low adherence. Developing personalized preventive programs considering the level of patient adherence may influence the effectiveness of treatment and improve metabolic health.