Objective: Clinical inertia, together with poor adherence to pharmacological treatment and lifestyle modifications, represents a major barrier to the effective management of chronic non-communicable diseases. This study aims to identify patterns of physician counselling on lifestyle changes and levels of participant adherence. Design and method: This cross-sectional study was part of the EH–UH 2 survey and included a total of 1,342 participants with completed questionnaires and comprehensive clinical data. Analyses were based on a structured questionnaire, anthropometric examination and 24-hour urine samples. Results: Women generally showed better adherence to physician advice regarding lifestyle modifications (weight control, salt intake, alcohol consumption, physical activity) than men. Few participants met the recommended daily salt intake, with higher adherence to physician advice among women than men (96.3% vs 85.7%; p = 0.121). Participants with obesity received weight-control advice more frequently than those who were overweight (67.2% vs 23.7%; p < 0.001), yet adherence was higher in the overweight group (87.9% vs 56.7%; p < 0.001). Salt-reduction adherence declined as salt intake increased, with women consistently adhering better (86.7% vs 83.3%; p = 0.029). For physical activity, adherence increased with baseline activity level, reaching highest compliance among already active participants, although clinical inertia remained substantial in less active groups (p < 0.001). Conclusions: Our findings highlight substantial gaps in preventive care. Primary care physicians should provide individualized advice, but limited time makes this challenging. Effective prevention requires the involvement of multiple stakeholders and the regular integration of lifestyle counselling into primary care practice. Permanent multi-sectoral programs should be led by the government.
Glavić et al. (Fri,) studied this question.