Abstract: SA-PO1067
Clinician Attitudes Toward Lowering Sodium Intake
Session Information
- Diet and Nutrition: Clinical
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1302 Health Maintenance, Nutrition, and Metabolism: Clinical
Authors
- Bhagwat, Manavi, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States
- Choudhury, Devasmita, Salem VA Medical Center, University of Virginia, Virginia Tech Carilion School of Medicine, Salem, Virginia, United States
Background
Lowering dietary sodium (Na) intake is of utmost importance for patients with hypertension (HTN), kidney, liver, and heart disease particularly when there is evidence for fluid retention, but patient adherence to low Na diets is suboptimal. Primary care practitioner (PCP) attitudes and prescription of low Na diets can impact adherence. To understand PCP attitudes, prescription and follow up of low Na diets, we administered a brief survey.
Methods
An email 8-question survey was sent to all 234 PCPs at the Salem VA Medical Center (Salem VAMC) and at Carilion Roanoke Memorial Hospital (CRMH) clinics. Questions asked PCP attitudes towards recommending Na restriction for medical conditions including HTN, kidney disease (KD), and lower extremity edema. Survey also queried PCP processes to determine dietary adherence.
Results
We received 57 responses (41 MD/DO, 16 PA/NP) with a 45% response rate at Salem VAMC and 40% at CRMH. PCPs self-reported varied diet instruction practices (Fig 1). 54% of respondents recommend patients with KD follow a low Na diet and 45% personally instruct patients on following a low Na diet. 13% of respondents gave KD patients dietitian referrals for low Na diet instruction. PCPs mostly checked adherence by asking hypertensive patients if they follow a low Na diet (Fig 2).
Conclusion
Of PCP respondents, 46% never discuss or prescribe a low Na diet to patients that can benefit from it. Of those that discuss or prescribe a low Na diet, <20% made a nutrition referral. There is also limited effort with dietary adherence follow up. Given significant variability in PCP practices and attitudes towards low Na diet prescription, suboptimal low Na diet adherence in patients is expected. Improving low Na diet instruction at PCP level can impact key patient risks factors for renal and cardiovascular morbidity.
Fig 1. Reported PCP frequency of low Na diet instruction to hypertensive pts
Fig 2. Self-reported methods of determining adherence to low Na diet