63-LB: Self-Reported Adherence among Cardiac Surgery Patients with Diabetes Mellitus

Successful cardiac surgery and recovery typically requires significant treatment adherence. For adults who undergo cardiac surgery and have diabetes mellitus (DM), the complex nature of behavior adherence is unique and especially demanding. Thus, we hypothesized that cardiac surgery patients with comorbid DM (CSDM) would report poorer treatment adherence than cardiac surgery patients without DM (CS).

In this secondary data analysis, we assessed self-reported adherence (diet, medications, appointments) among CSDM (N=51) and CS (N=240) pre- and 3 months post-operatively. Participants were predominately male (64%), middle aged (M=63, SD=14), and presented for valve (N=137), coronary artery bypass graft (CABG; N=42), valve + CABG (N=57), or another cardiac (N=55) surgeries. Chi-square analyses assessed differences in self-reported adherence (adherent/not adherent/not applicable) by DM diagnosis (yes/no). Pre-operatively, CSDM were more likely to endorse that following any specific diet was applicable to them (70% vs. 50%), yet reported higher rates of dietary nonadherence (42%) than CS (29%), x2(2)=7.2, p=.027. Rates of medication (p=.420) or appointment (p=.875) adherence did not differ by DM diagnosis. At follow-up, a greater proportion of participants reported that dietary adherence was applicable to them (CSDM: 94%; CS: 74%), still with greater rates of non-adherence for CSDM (81%) compared to CS (55%), x2(2)=7.7, p=.021. Medication adherence (p=.570) and appointment attendance (p=.054) did not differ between groups.

In this sample, CSDM seemed more aware of the importance of healthy diet, but were less likely to adhere to a diet (low sugar, sodium) than CS. This pattern may be due to greater awareness of dietary restrictions among patients with DM, as well as additional burden. Cardiac surgery patients with comorbid DM may benefit from additional support from dieticians and psychologists to address the complex psychosocial nature of dietary adherence in comorbid health conditions.