FACTORS INFLUENCING COMPLIANCE WITH DIETARY REGIMEN AMONG RENAL OUT-PATIENTS IN UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Kidney Diseases (KD) are among the non-communicable diseases with high prevalence in recent times especially in developing countries. Despite the significant role of diets in management of KD, there have been conflicting reports on levels of patients' compliance with dietary regimen. This study therefore was designed to identify factors influencing compliance with dietary regimen among Renal Patients (RP) in the University College Hospital (UCH), Ibadan, Nigeria. This cross-sectional study involved 203 consenting respondents purposively selected during outpatient clinic days. A pre-tested interviewer-administered questionnaire was used to obtain information on the socio-demographic characteristics, level of compliance and factors influencing compliance with dietary regimen. Compliance with dietary regimen was assessed using a 20-points scale categorised into poor (<8), moderate (8-14) and good (>14) respectively. Data were analysed using descriptive statistics, Chi-square test and logistic regression model with level of significance at 5%. Age of respondents was 46.5 ± 13.2 years, 50.7% were males, 79.8% were married, 36.5% completed secondary education and 88.7% did not smoke or consume alcohol. Compliance score with dietary regimen was 13.7 ± 3.5 and 74.4% had good dietary compliance. Eighty four percent of RP with good compliance easily, obtained permission from workplace to attend clinic appointments compared to 9.35% and 6.7% of respondents with moderate and poor compliance respectively. Most (79.3%) were satisfied with the recommended diets and 55.2% managed to comply with extended duration of their dietary treatment. In addition, 83.3% were able to adapt with prolonged time of waiting to see their doctor/dietitian during scheduled appointment. Also, 84.2% reported that counseling by health care providers enhanced good compliance. Sixty-six percent reported smoking or alcohol consumption could inhibit compliance and 81.8% reported that having knowledge of the sign and symptoms of KD enhanced composition. Majority (80.8%) of the Renal Patients reported that they were able to cope with taking low salt in their diet while 74.9% always follow strictly the meal plan by their dietitians and 75.0% did not buy food from food vendors. Furthermore, having responsible and caring spouses (79.0%) and highest level education (80.3%) were factors found to promote dietary compliance. Respondents who neither smoked nor consumed alcohol were more likely to comply with

dietary regimen (OR=4.71, CI=4.39-5.13). The RP who received counselling from health care providers were more likely to comply with dietary regimen than those who received no counseling (OR =3.57, CI=1.34-10.79). Compliance with dietary regimen among respondents was good. Support from the family, workplace, counseling and self-discipline influenced compliance among Renal Patients. Therefore, good compliance with dietary regimen should be fostered when social support is extended beyond the clinic settings.