Doctor-patient communication about nutrition on related secondary preventive behaviours, especially for hypertension

Inadequate consumption of fruit and vegetables and salt intake are two major factors that can play a role in increased to secondary prevention behaviours. Doctor-patient relationship intervenes on the adherence of these advices. For hypertension, hypercholesterolemia, diabetes, overweight and obesity, our study’s aim was to analyse the associations between the quality of the doctor-patient communication, evaluated in 2013, and patients’ adherence to their general practitioner (GP)’s nutritional advices, between 2008 and 2013.
Methods
Performed by the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg, 4391 patients were contacted. Five years after a coronary angiography, 1289 completed a self-rating questionnaire assessing the GP’Com-5 items scale (Cronbach 0.87). The variables were analysed with a multiple logistic regression model.
Results
Patients declared that 57.9% reduced or stopped their consumption of salt intake, whereas 65% increased their consumption of fresh fruits and vegetables. Around 37% of the patients reported having made changes following the advice of their doctor. An increased consumption of fresh fruits and vegetables was linked with the quality of doctor-patient communication when patients were hypertension (odd ratio (OR) = 1.084, IC 95%, [1.017-1.157]), overweight (1.081 [1.013-1.155]), obesity (OR = 1.130 [1.056-1.209]), hypercholesterolemia (OR = 1.102 [1.033–1.175]) and diabetes (OR = 1.103 [1.029-1.181]). The decreased of salt intake consumption was associated with the quality of physician-patient communication when the patient was hypertension (OR = 1.102 [1.034 – 1.176]).
Conclusion
Doctor-patient communication is a relevant determinant in obtaining a favourable behavioural outcome, especially on nutrition. The rehabilitation program must promote more exchange and telephone assistance to develop a mutual engagement.