Living with Diabetes and Hypertension in a Resource-limited Setting of Rural Bengaluru, India: A Cross-sectional Study

Abstract Introduction: Hypertension (HTN) and diabetes mellitus (DM) are the major contributors to cardiovascular disease. This study aimed to assess adherence patterns and identify barriers and facilitators amongst individuals with DM and/or HTN residing in villages under the Mugalur subcentre. Materials and Methods: This cross-sectional study was conducted amongst 225 adults with DM and/or HTN for more than 2 years across 12 villages. Medication adherence was assessed with the Brief Adherence Rating Scale (BARS), while diet and physical activity adherence were evaluated using a semi-structured questionnaire. Depression and cognitive impairment were prediagnosed conditions in the participants. Only mild cases were included in the study, and these diagnoses were reconfirmed at enrolment using the Patient Health Questionnaire-9 for depression and the Mini-Mental State Examination for cognitive impairment. Results: Adherence was the highest for medication (91%), followed by exercise (78%) and diet (44%). Facilitators included reminders (through SMS, phone call, WhatsApp, etc.) follow-up visits, literacy, assistance and social support. Barriers included sensory impairment, cognitive issues, time constraints and musculoskeletal pain. Medication adherence was higher with normal vision (adjacent odds ratio [AOR]: 3.14) and schooling (AOR: 3.09). Diet adherence was greater with normal vision (AOR: 3.10) but lower among males. Exercise adherence improved with reminders (AOR: 0.35). Conclusions: Medication adherence exceeded lifestyle adherence. Vision, education, gender and reminders significantly influenced adherence, highlighting the need for targeted supportive strategies.