Cardiometabolic Patient-Related Factors Influencing the Adherence to Lifestyle Changes and Overall Treatment: A Review of the Recent Literature

Overview

Journal Life (Basel)

Specialty Biology

Date 2023 May 27

PMID 37240798

Authors

Vasiliki Kalantzi

Ioanna Panagiota Kalafati

Vasiliki Belitsi

Thomas Tsiampalis

Ioannis Koutsonasios

Odysseas Androutsos

Fotini Bonoti

Demosthenes B Panagiotakos

Rena I Kosti

Affiliations

Soon will be listed here.

Abstract

It is well acknowledged that most of the modifiable risk factors for Cardiovascular Diseases (CVDs) can be averted through lifestyle modifications beyond medication adherence. This review aims to critically evaluate the cardiometabolic (CM) patient-related factors that influence the adherence to lifestyle changes studied alone and/or in combination with medication. A comprehensive literature search of PubMed articles from 2000 to 2023 retrieved 379 articles. After removing the articles which were not relevant, a total of 28 cross-sectional studies was chosen (12 qualitative, and 16 quantitative). The findings confirmed that five groups of factors influence patients' adherence to overall treatment: (1) health beliefs, knowledge, and perceptions regarding the risks and challenges of disease and medication intake along with adherence process perceptions; (2) self-concept; (3) emotions; (4) patient-healthcare providers relationship/communication and (5) social and cultural interactions. It is worth mentioning that cultural issues, such as culinary particularities, ethnic identity, social life as well as patients' skills and abilities, play a profound role in the effectiveness of the recommended lifestyle modifications beyond the aforementioned common factors. The need for clear-cut culturally adapted guidelines along with personalized advice from physicians is imperative as it could improve patients' self-efficacy. These socio-psychological factors should be seriously considered as a means to increase the effectiveness of future community prevention programs.

Citing Articles

Treatment Adherence and Health-Related Quality of Life Among Patients with Hypertension at Tertiary Healthcare Facility in Lalitpur, Nepal: A Cross-Sectional Study.

Rupakheti B, Kc B, Bista D, Kc S, Pandey K Patient Prefer Adherence. 2024; 18:2077-2090.

PMID: 39371197 PMC: 11453163. DOI: 10.2147/PPA.S476104.

Exploring the Need and Benefits of Digital Therapeutics (DTx) for the Management of Heart Failure in India.

Singh B, Hazra P, Roy S, Garg R, Bhat S, Patki N Cureus. 2024; 15(11):e49628.

PMID: 38161874 PMC: 10755686. DOI: 10.7759/cureus.49628.

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study.

Belitsi V, Tsiampalis T, Kouvari M, Kalantzi V, Androutsos O, Bonoti F Life (Basel). 2023; 13(9).

PMID: 37763284 PMC: 10532979. DOI: 10.3390/life13091880.

References

Hultgren F, Jonasson G, Billhult A . From resistance to rescue--patients' shifting attitudes to antihypertensives: a qualitative study. Scand J Prim Health Care. 2014; 32(4):163-9. PMC: 4278392. DOI: 10.3109/02813432.2014.982365. View

Tarn D, Barrientos M, Pletcher M, Cox K, Turner J, Fernandez A . Perceptions of Patients with Primary Nonadherence to Statin Medications. J Am Board Fam Med. 2021; 34(1):123-131. PMC: 8903053. DOI: 10.3122/jabfm.2021.01.200262. View

Pina I, Di Palo K, Brown M, Choudhry N, Cvengros J, Whalen D . Medication adherence: Importance, issues and policy: A policy statement from the American Heart Association. Prog Cardiovasc Dis. 2020; 64:111-120. DOI: 10.1016/j.pcad.2020.08.003. View

Khunti K, Seidu S, Kunutsor S, Davies M . Association Between Adherence to Pharmacotherapy and Outcomes in Type 2 Diabetes: A Meta-analysis. Diabetes Care. 2017; 40(11):1588-1596. DOI: 10.2337/dc16-1925. View

Krishnamoorthy Y, Rajaa S, Rehman T, Thulasingam M . Patient and provider's perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis. BMJ Open. 2022; 12(3):e055226. PMC: 8948385. DOI: 10.1136/bmjopen-2021-055226. View

Sarfo F, Mobula L, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O . Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study. PLoS One. 2018; 13(3):e0193494. PMC: 5858765. DOI: 10.1371/journal.pone.0193494. View

Rimando M . Perceived Barriers to and Facilitators of Hypertension Management among Underserved African American Older Adults. Ethn Dis. 2015; 25(3):329-36. PMC: 4671409. DOI: 10.18865/ed.25.3.329. View

Thomas C . The influence of self-concept on adherence to recommended health regimens in adults with heart failure. J Cardiovasc Nurs. 2007; 22(5):405-16. DOI: 10.1097/01.JCN.0000287037.85067.3d. View

Ruf V, Stewart S, Pretorius S, Kubheka M, Lautenschlager C, Presek P . Medication adherence, self-care behaviour and knowledge on heart failure in urban South Africa: the Heart of Soweto study. Cardiovasc J Afr. 2010; 21(2):86-92. PMC: 3721814. View

10.

Schneider A, Gaedke M, Garcez A, Barcellos N, Paniz V . Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies. Int J Clin Pract. 2017; 72(1). DOI: 10.1111/ijcp.13044. View

11.

Chiou A, Wang H, Chan P, Ding Y, Hsu K, Kao H . Factors associated with behavior modification for cardiovascular risk factors in patients with coronary artery disease in northern Taiwan. J Nurs Res. 2009; 17(3):221-30. DOI: 10.1097/JNR.0b013e3181b2559a. View

12.

Murray J, Fenton G, Honey S, Bara A, Hill K, House A . A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk. BMC Cardiovasc Disord. 2013; 13:48. PMC: 3716917. DOI: 10.1186/1471-2261-13-48. View

13.

Darr A, Astin F, Atkin K . Causal attributions, lifestyle change, and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the United Kingdom. Heart Lung. 2008; 37(2):91-104. DOI: 10.1016/j.hrtlng.2007.03.004. View

14.

Jankowska-Polanska B, Blicharska K, Uchmanowicz I, Morisky D . The influence of illness acceptance on the adherence to pharmacological and non-pharmacological therapy in patients with hypertension. Eur J Cardiovasc Nurs. 2016; 15(7):559-568. DOI: 10.1177/1474515115626878. View

15.

Cole J, Smith S, Hart N, Cupples M . Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study. BMC Fam Pract. 2013; 14:126. PMC: 3765931. DOI: 10.1186/1471-2296-14-126. View

16.

Moore S, McEvoy C, Prior L, Lawton J, Patterson C, Kee F . Barriers to adopting a Mediterranean diet in Northern European adults at high risk of developing cardiovascular disease. J Hum Nutr Diet. 2017; 31(4):451-462. DOI: 10.1111/jhn.12523. View

17.

Henao Lopez V, Trivino Vargas Z . Adherence to Secondary Prevention and Influential Factors in Individuals with Coronary Angioplasty. Invest Educ Enferm. 2020; 38(3). PMC: 7885540. DOI: 10.17533/udea.iee.v38n3e05. View

18.

Hardcastle S, Legge E, Laundy C, Egan S, French R, Watts G . Patients' perceptions and experiences of familial hypercholesterolemia, cascade genetic screening and treatment. Int J Behav Med. 2014; 22(1):92-100. DOI: 10.1007/s12529-014-9402-x. View

19.

Claassen L, Henneman L, Kindt I, Marteau T, Timmermans D . Perceived risk and representations of cardiovascular disease and preventive behaviour in people diagnosed with familial hypercholesterolemia: a cross-sectional questionnaire study. J Health Psychol. 2010; 15(1):33-43. DOI: 10.1177/1359105309345170. View

20.

Thomas N, Alder E, Leese G . Barriers to physical activity in patients with diabetes. Postgrad Med J. 2004; 80(943):287-91. PMC: 1742997. DOI: 10.1136/pgmj.2003.010553. View