Audit of healthy lifestyle behaviors among patients with diabetes and hypertension attending ambulatory health care services in the United Arab Emirates

Background: Knowledge is limited on healthy lifestyle behaviors and their associations with glycemic and blood pressure control among patients with diabetes and hypertension in the United Arab Emirates (UAE). Objective: To examine healthy lifestyle behaviors and their associations with glycemic and blood pressure control among patients with hypertension and diabetes, and improvement after the implementation of an intervention in a Chronic Disease Program. Subjects: All patients with diabetes or hypertension attending seven primary health care centers in Al Ain, UAE during a designated three-week period in July and August 2009. Method: Nurses conducted an audit of patients’ adherence to health lifestyle behaviors related to meal planning, smoking, exercise, blood glucose and blood pressure monitoring at home, and foot and eye exams in the Chronic Disease Program clinics after a self-management intervention. A perceived knowledge score and discussion scores (based on the frequency the patients discuss diabetes and hypertension management issues with their providers) were calculated. Data were analyzed using linear regression and odds ratios. Results: Patients reported acceptable rates of adherence to healthy lifestyle behaviors, including a low smoking rate (6% in males), following a meal plan and exercising (88.6% and 78.7%, respectively). Among patients with diabetes, 59% tested their blood glucose levels at least once a week compared to only 15.3% of those with hypertension monitoring their blood pressure levels at home. Only 33% of the participants were following the current physical activity recommendations. Healthy lifestyle behaviors fell into the following clusters: meal planning with exercise (odds ratio (OR): 8.9 [3.3-23.7]), meal planning with foot exams (OR: 10.6 [3.4-32.9]) and exercising and foot exams (OR: 5.2 [1.9-14.2]). Conclusion: This practice-based audit provides an essential assessment for future interventions to improve adherence to healthy life style behaviors among patients with diabetes and hypertension attending primary health clinics in the UAE.