Investigating the Causes of Non-adherence to Recommended Lifestyle Modifications Among Indian Patients With Newly Diagnosed Type 2 Diabetes Mellitus or Hypertension

Background and objective Lifestyle modification (related to diet and physical activity) is a key part of treatment for patients diagnosed with type 2 diabetes or hypertension. However, many patients are unable to follow the prescribed lifestyle modifications. This study aimed to investigate the causes of non-adherence in Indian adult patients with newly diagnosed type 2 diabetes mellitus (T2DM) or hypertension, who were advised lifestyle modifications along with pharmacotherapy. Problems encountered in observing adherence were recorded, and suggestions on how patient adherence may be improved were obtained after six months of treatment from patients and their family members using questionnaires and interviews. Methods A total of 80 patients (40 female) with newly diagnosed diabetes and/or hypertension, without any physical disability that would hinder exercise, were initially enrolled in the study. The patients and their families attended counseling sessions conducted at the hospital or at the patient's residence at the time of treatment initiation. Twenty male patients dropped out within two months due to various reasons; their data were not included in this study. After six months of therapy, questionnaires related to lifestyle adherence were filled out by the patients. Patients and their relatives were interviewed regarding the problems associated with adherence and for suggestions on how adherence could be improved. Data obtained from 40 female and 20 male patients were used in the analysis. Results Adherence to lifestyle modifications was reported in all male patients who continued to participate in the study and 62.8% of female patients. All female patients with independent income reported good adherence. All patients reported their children's cooperation in helping them adhere to lifestyle changes. In the case of financially dependent female patients, adherence positively correlated with the presence of spouse and family members at the counseling session. A negative correlation was observed between the number of members in the household and the number of members who missed the counseling session. Regulation of diet and exercise was difficult in the case of female patients, especially those living in joint families. Conclusions Counseling the entire family is essential in the case of female patients to improve their adherence to lifestyle modifications. All children in the family who are old enough to comprehend dietary and physical activity changes should be included in the counseling sessions, which entail educating them about lifestyle diseases (obesity, T2DM, and hypertension).