Factors associated with non-compliance of diet counseling among hyperlipidemic patients in HASA and CTC Sungai Buloh

Hyperlipidemia is a common metabolic disorder characterized by high levels of lipids and lipoproteins in the blood, which increases the risk of cardiovascular diseases. This study aimed to identify factors associated with non-compliance with diet counseling among hyperlipidemic patients in the Outpatient Department (OPD) Clinic of Hospital Al-Sultan Abdullah UiTM (HASA) and Clinical Training Centre (CTC) Sungai Buloh, Selangor, Malaysia. This retrospective and cross-sectional study was conducted using a mixed-method approach and divided into 2 phases. Phase 1 included a quantitative study with 110 participants, retrieving sociodemographic, anthropometric, medical, biochemical, and dietary information through a secondary data questionnaire. Phase 2 consists of a qualitative study involving 10 participants, adopting a grounded theory approach for semi-structured interviews. Most participants were middle-aged (57.3%) males (58.2%), predominantly Malay (90.0%) with a high prevalence of comorbidities such as diabetes (65.5%) and hypertension (66.4%). Many participants were overweight (33.6%) or obese 1 (31.8%) and exhibited elevated HbA1c (7.4 ± 2.0) and low HDL-C levels (1.4 ± 0.4). Dietary intake remained constant despite two diet counseling, while significant changes in total cholesterol (p=0.02) and triglycerides (p=0.05) were improved following initial diet consultations. 10 subjects in the qualitative study revealed knowledge domain (understanding cholesterol, understanding saturated fats, and understanding unsaturated fats), practice domain (changes in food choices, changes in individual behavior, and changes in food purchasing), and barriers to adherence to diet counseling domain (patient-related factor, social and environmental factor, and healthcare-related factor) were identified as factors association to compliance to diet counseling among hyperlipidemic patients. Understanding the nutritional status, knowledge, practices, and barriers associated with diet consultations is critical for effective diet adherence and interventions.