Physicians’ Words, Patients’ Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Scope
2.2. Setting
2.3. Sample
2.4. Eligibility Criteria
2.5. Bioethics
2.6. Measurements
2.6.1. Lifestyle Counselling
2.6.2. Dietary and Lifestyle Characteristics
2.6.3. Socio-Demographic, Anthropometric, and Clinical Characteristics
2.7. Statistical Analysis
3. Results
4. Discussion
Importance of Physicians’ Recommendations on Adherence Level to the Mediterranean Diet
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Level of Adherence to Mediterranean Diet | ||||
---|---|---|---|---|
Total Sample (N = 1988) | Low Adherence (N = 912) | High Adherence (N = 1076) | p-Value | |
Demographic characteristics | ||||
Sex (N (%) female) | 1180 (59.4) | 536 (58.8) | 644 (59.9) | 0.625 |
Age (in years; mean (SD)) | 63.9 (13.4) | 62.8 (13.3) | 64.8 (13.4) | <0.001 |
Level of education (N (%)) | <0.001 | |||
Primary education | 351 (17.7) | 153 (16.8) | 198 (18.4) | |
Secondary education | 985 (49.6) | 497 (54.5) | 488 (45.4) | |
Higher-tertiary education | 651 (32.8) | 262 (28.7) | 389 (36.2) | |
Occupational status (N (%)) | <0.001 | |||
Employed/freelance | 1225 (61.6) | 621 (68.1) | 604 (56.1) | |
Unemployed/retired | 763 (38.4) | 291 (31.9) | 472 (43.9) | |
Marital status (N (%)) | 0.907 | |||
Married/cohabitation | 1328 (66.8) | 608 (66.7) | 720 (66.9) | |
Other (single, widowed, divorced) | 660 (33.2) | 304 (33.3) | 356 (33.1) | |
Income (N (%)) | <0.001 | |||
Less than EUR 18,000 /year | 1402 (70.5) | 691 (75.8) | 711 (66.1) | |
More than EUR 18,000 /year | 586 (29.5) | 221 (24.2) | 365 (33.9) | |
Clinical characteristics (N (%)) | ||||
Hypertension | 1141 (57.4) | 468 (51.3) | 673 (62.5) | <0.001 |
Type II diabetes | 370 (18.6) | 154 (16.9) | 216 (20.1) | 0.069 |
Type I diabetes | 64 (3.2) | 35 (3.8) | 29 (2.7) | 0.150 |
Hypercholesterolaemia | 735 (37) | 282 (30.9) | 453 (42.1) | <0.001 |
Increased triglycerides levels | 354 (17.8) | 145 (15.9) | 209 (19.4) | 0.041 |
Obesity | 251 (12.6) | 133 (14.6) | 118 (11.0) | 0.016 |
Coronary artery disease | 352 (17.7) | 152 (16.7) | 200 (18.6) | 0.264 |
Stroke | 126 (6.3) | 74 (8.1) | 52 (4.8) | 0.003 |
Kidney disease | 120 (6.0) | 75 (8.2) | 45 (4.2) | <0.001 |
Non-alcoholic fatty liver disease | 115 (5.8) | 56 (6.1) | 59 (5.5) | 0.532 |
Lifestyle characteristics(N (%)) | ||||
Physical activity | 1213 (61.0) | 499 (54.7) | 714 (66.4) | <0.001 |
Current smoker | 629 (31.6) | 282 (30.9) | 347 (32.2) | 0.526 |
Past smoker | 363 (26.7) | 123 (19.5) | 240 (32.9) | <0.001 |
Passive smoking | 662 (48.7) | 217 (34.4) | 445 (61.1) | <0.001 |
Have You Been Given Clear Recommendations by Your Doctor Regarding Your Lifestyle Due to Your Illness? | |||
---|---|---|---|
No (N= 145) | Yes (N= 1843) | p-Value | |
Demographic characteristics | |||
Sex (N (%)) | 0.490 | ||
Male | 55 (37.9) | 753 (40.9) | |
Female | 90 (62.1) | 1090 (59.1) | |
Educational level (N (%)) | <0.001 | ||
Primary education | 44 (30.3) | 307 (16.7) | |
Secondary education | 54 (37.2) | 931 (50.5) | |
Higher-tertiary education | 47 (32.4) | 604 (32.8) | |
Occupational status (N (%)) | <0.001 | ||
Employed/freelance | 66 (45.5) | 1159 (62.9) | |
Unemployed/retired | 79 (54.5) | 684 (37.1) | |
Marital status (N (%)) | 0.980 | ||
Married/cohabitation | 97 (66.9) | 1231 (66.8) | |
Other (single, widowed, divorced) | 48 (33.1) | 612 (33.2) | |
Income level (N (%)) | 0.236 | ||
Less than EUR 18,000 /year | 96 (66.2) | 1306 (70.9) | |
More than EUR 18,000 /year | 49 (33.8) | 537 (29.1) | |
Clinical characteristics (N (%)) | |||
Hypertension | 83 (57.2) | 1058 (57.4) | 0.969 |
Type II diabetes | 38 (26.2) | 332 (18) | 0.015 |
Type I diabetes | 4 (2.8) | 60 (3.3) | 0.744 |
Hypercholesterolaemia | 61 (42.1) | 674 (36.6) | 0.187 |
Increased triglycerides levels | 58 (40) | 296 (16.1) | <0.001 |
Obesity | 28 (19.3) | 223 (12.1) | 0.012 |
Coronary artery disease | 16 (11) | 336 (18.2) | 0.029 |
Stroke | 4 (2.8) | 122 (6.6) | 0.066 |
Kidneydisease | 8 (5.5) | 112 (6.1) | 0.785 |
Non-alcoholic fatty liver disease | 3 (2.1) | 112 (6.1) | 0.047 |
Lifestyle characteristics (N (%)) | |||
Level of adherence to Mediterranean diet—High | 77 (53.1) | 1183 (64.2) | 0.035 |
Physical activity—Yes | 91 (62.8) | 1251 (67.9) | 0.016 |
Curent smoking status—No | 105 (72.4) | 1436 (77.9) | 0.028 |
Past smoking status—No | 65 (61.9) | 931 (74.2) | 0.006 |
Passive smoking—No | 49 (46.7) | 647 (51.6) | 0.328 |
Main Independent Variable: Have You Been Given Clear Recommendations by Your Doctor Regarding Your Lifestyle Due to Your Illness? (Yes Vs. No) | Odds Ratio (OR) | 95% Confidence Interval (95% CI) | |
---|---|---|---|
Model 1 | Dependent Variable: Current smoking (no vs. yes) | 1.34 | 1.13–1.42 |
Model 2 | Dependent Variable: Physical activity (yes vs. no) | 1.25 | 1.12–1.38 |
Model 3 | Dependent Variable: Level of adherence to Mediterranean diet (high vs. low) | 1.82 | 1.52–2.02 |
Model 4 | Dependent Variable: Adhering to dietary recommendations for vegetables—eat four servings of a variety of vegetables each day (yes vs. no) | 1.51 | 0.53–4.31 |
Model 5 | Dependent Variable: Adhering to dietary recommendations for fruits—eat three servings of a variety of fruit each day (yes vs. no) | 1.39 | 0.81–2.38 |
Model 6 | Dependent Variable: Adhering to dietary recommendations for cereals (bread, rice, pasta) and potatoes—consume from five to eight servings of a variety of grains per day. The largest amount of these should be wholemeal. Of these servings, potato consumption should be about three servings per week (yes vs. no) | 2.55 | 1.34–4.84 |
Model 7 | Dependent Variable: Adhering to dietary recommendations for red meat—consume up to one serving of lean red meat per week. Of this, as little as possible should be processed (yes vs. no) | 1.52 | 1.02–2.26 |
Model 8 | Dependent Variable: Adhering to dietary recommendations for legumes—consume at least three servings of legumes per week (yes vs. no) | 3.38 | 2.40–4.77 |
Model 9 | Dependent Variable: Adhering to dietary recommendations for fish—eat from two to three servings of a variety of fish and seafood per week. Make sure at least half of your servings are oily fish (e.g., sardines, anchovies, flounder, pollock, flounder), which are high in omega-3 fats (yes vs. no) | 1.08 | 0.69–1.71 |
Model 10 | Dependent Variable: Adhering to dietary recommendations for eggs—consume up to four eggs per week, including those used to make food and desserts (yes vs. no) | 0.37 | 0.23–0.57 |
Model 11 | Dependent Variable: Adhering to dietary recommendations for dairy products–consume two servings of a variety of dairy products per day. Prefer semi-skimmed milk and yogurt (1.5–2% fat) and low-fat cheeses (yes vs. no) | 0.29 | 0.20–0.40 |
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Tsiampalis, T.; Kouvari, M.; Belitsi, V.; Kalantzi, V.; Androutsos, O.; Bonoti, F.; Panagiotakos, D.B.; Kosti, R.I. Physicians’ Words, Patients’ Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study. Healthcare 2023, 11, 2982. https://doi.org/10.3390/healthcare11222982
Tsiampalis T, Kouvari M, Belitsi V, Kalantzi V, Androutsos O, Bonoti F, Panagiotakos DB, Kosti RI. Physicians’ Words, Patients’ Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study. Healthcare. 2023; 11(22):2982. https://doi.org/10.3390/healthcare11222982
Chicago/Turabian StyleTsiampalis, Thomas, Matina Kouvari, Vasiliki Belitsi, Vasiliki Kalantzi, Odysseas Androutsos, Fotini Bonoti, Demosthenes B. Panagiotakos, and Rena I. Kosti. 2023. "Physicians’ Words, Patients’ Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study" Healthcare 11, no. 22: 2982. https://doi.org/10.3390/healthcare11222982