Stress as a risk factor for noncompliance with treatment regimens in patients with diabetes and hypertension.
BACKGROUND
We have assessed the role of stress on compliance of patients with diabetes mellitus (DM) and hypertension (HTN) with taking prescribed medications and following dietary and exercise regimens.


METHODS
A total of 9544 individuals more than 19 years of age were selected from three counties in central Iran. The presence of DM and HTN were asked from participants. We defined treatment adherence (compliance) based on agreement of individual's self-report behavior with recommendations from a physician.


RESULTS
Awareness about DM and HTN was 82.6% and 49.9%, respectively. Multivariate analysis showed that odds ratio (OR) of high to low stress level was lower than one for both "usage of medication" and "following exercise regimen" in diabetics even after adjustment for either "age and sex" or "age, sex and education". In hypertensive patients, OR of high to low stress level was lower than one for "usage of medication" even after adjustment for either "age and sex" or "age, sex and education" and also lower than one for "following exercise regimen" only as crude index.


CONCLUSIONS
Cases with higher stress level had lower compliance for accepting either medication or exercise as a treatment option for their DM or HTN.
Assistant Professor, Department of Mental Health, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Hamidreza
H
Roohafza
Assistant Professor, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Ali
A
Kabir
Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Masoumeh
M
Sadeghi
PhD Fellow, Department of Endocrinology and Diabetes, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Pedram
P
Shokouh
Assistant Professor, Mental Health Research Center, Tehran Institute of Psychiatry AND School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
Masoud
M
Ahmadzad-Asl
Associate Professor, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Akbar
AA
Khadem-Maboudi
Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Nizal
N
Sarrafzadegan
Diabetes Mellitus; Exercise; Hypertension; Patient Compliance; Risk Factors; Stress