Suleiman, Amal Khalil Turki
(2010)
Adherence To Medication Among
Hypertensive Outpatients In The
Penang General Hospital, Malaysia.
PhD thesis, Universiti Sains Malaysia.
Abstract
Adherence to antihypertensive medications in general is not well documented in
developing countries, and what is known is far from encouraging. Despite the
effectiveness of antihypertensive treatment, medication adherence is often suboptimal in
hypertensive Malaysian population. This retro-prospective cohort study aimed to assess
the medication adherence, and factors affecting this. A cohort of 380 hypertensive
patients was conveniently recruited from the outpatient hypertension clinic at Penang
General Hospital, Malaysia. The Morisky self-report scale revealed that 51.3% patients
(n=195) had poor adherence to prescribed antihypertensive medication. A Semistructured
interview revealed forgetfulness due to a lack of symptoms; poor social
support, medication side effects, and the perception that long-term medication may be
addictive were principal factors of poor adherence to medication. The structural equation
modelling (SEM), which identified the multivariate hypothesized predictors of poor
adherence to medication, showed that a lack of self discipline, aversion towards
medication, and a negative attitude towards medication in general negatively accounted
for 75% of factors affecting medication adherence. The one-way ANOVA and
independent t-tests of independent samples revealed no statistically significant
differences (p>0.05 for all) between adherent and non-adherent patients with regards to
demographic variables, including age, gender, family history of hypertension, race,
educational level, and income.
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