Knowledge, Attitudes, and Practices Regarding the Dual Burden of Diabetes and Hypertension in Khyber Pakhtunkhwa, Pakistan

Abstract

Background: Non communicable diseases (NCDs) are now the leading cause of adult mortality in Pakistan, accounting for nearly 60 % of all deaths. Among these, diabetes mellitus and hypertension constitute the two most prevalent and interrelated metabolic disorders.

Objective: To assess community Knowledge, Attitudes, and Practices (KAP) regarding the dual burden of diabetes mellitus (DM) and hypertension (HTN) in order to guide integrated public health efforts.

Study Design: A mixed methods study.

Settings: Major government hospitals and community camps in Khyber Pakhtunkhwa, Pakistan, coordinated by the Darwesh Diabetes Research Institute (DDRI).

Duration: January 2024 to June 2024.

Methods: The study recruited 580 adults. Data were collected using a structured KAP questionnaire and supplemented by limited qualitative interviews. Quantitative data were analyzed using descriptive statistics and logistic regression, while qualitative data were examined using thematic content analysis.

Results: Participants showed high awareness (mean knowledge score 11.8±2.6) and positive attitudes (mean score 37.2±4.5). However, this translated into only modest practice (mean practice score 8.1±2.7). Significant predictors of good practice included higher education, urban residence, and continuous clinical contact (p<0.001).

Qualitative findings identified key barriers: dietary misconceptions, gender based restrictions on physical activity, and fatalistic beliefs about chronic disease.

Conclusion: There is a significant gap between knowledge and practice in managing DM and HTN. The findings emphasize the critical need for integrated education, dual risk screening, and culturally sensitive interventions to address the identified barriers and improve preventive practices.

Keywords: Diabetes mellitus, hypertension, knowledge attitude practice, non communicable diseases, DDRI.