TY - JOUR
T1 - Exploring stroke survivors’ self-efficacy in understanding and takingmedication and determining associated factors
T2 - A cross-sectional study in a neurology clinic in Malaysia
AU - Appalasamy, Jamuna Rani
AU - Joseph, Joyce Pauline
AU - Ramaiah, Siva Seeta
AU - Quek, Kia Fatt
AU - Zain, Anuar Zaini Md
AU - Tha, Kyi Kyi
N1 - Funding Information:
The authors would like to thank the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia for their financial, material, and other support. The authors wish to acknowledge the contributions of doctors, clinic nurses and patients from the Neurology Clinic, Hospital Kuala Lumpur. We are grateful to the head of the Clinical Research Centre of Hospital Kuala Lumpur and the head of the Neurology Clinic of Hospital Kuala Lumpur for their support and approval for conducting this study. We would like to thank the Director General of Health Malaysia for his permission to publish this article. This study was part of research performed by JRA in fulfillment of her PhD from Monash University.
Publisher Copyright:
© 2019 Appalasamy et al.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/8/28
Y1 - 2019/8/28
N2 - Background and aim: Evidence-based prescribing practices for stroke-preventive medication have benefited stroke survivors; however, medication-nonadherence rates remain high. Medication understanding and use self-efficacy (MUSE) has shown great importance in medication-taking behavior, but its relationship with medication nonadherence in strokepreventive regimens lacks exploration. The aim of this study was to determine the prevalence of MUSE and its association with nonadherence causes and other potential factors among stroke survivors in Malaysia. Methods: This cross-sectional study was conducted among 282 stroke patients who provided informed consent and were in follow-up at theNeurology Outpatient Department of HospitalKuala Lumpur, Malaysia. The study employed a data-collection form that gathered information on sociodemographics, clinical treatment, outcome measures on MUSE, and medication-nonadherence reasons. Results: The prevalence of poor medication understanding and use self-efficacy among stroke patients was 46.5%, of which 29.1% had poor “learning about medication” self-efficacy, while 36.2% lacked self-efficacy in taking medication. Beliefs about medicine (74.02%) was the commonest reason for medication nonadherence, followed by medication-management issues (44.8%). In the multivariate model, independent variables significantly associated with MUSE were health literacy (AOR 0.2, 95% CI 0.069-0.581; P=0.003), medication-management issues (AOR 0.073, 95% CI 0.020-0.266; P<0.001), multiple-medication issues (AOR 0.28, 95% CI 0.085-0.925; P=0.037), beliefs about medicine (AOR 0.131, 95% CI 0.032-0.542; P=0.005), and forgetfulness/convenience issues (AOR 0.173, 95% CI 0.050-0.600; P=0.006). Conclusion: The relatively poor learning about medication and medication-taking self-efficacy in this study was highly associated with health literacy and modifiable behavioral issues related to nonadherence, such as medication management, beliefs about medicine, and forgetfulness/ convenience. Further research ought to explore these underlying reasons using vigorous techniques to enhance medication understanding and use self-efficacy among stroke survivors to determine cause-effect relationships.
AB - Background and aim: Evidence-based prescribing practices for stroke-preventive medication have benefited stroke survivors; however, medication-nonadherence rates remain high. Medication understanding and use self-efficacy (MUSE) has shown great importance in medication-taking behavior, but its relationship with medication nonadherence in strokepreventive regimens lacks exploration. The aim of this study was to determine the prevalence of MUSE and its association with nonadherence causes and other potential factors among stroke survivors in Malaysia. Methods: This cross-sectional study was conducted among 282 stroke patients who provided informed consent and were in follow-up at theNeurology Outpatient Department of HospitalKuala Lumpur, Malaysia. The study employed a data-collection form that gathered information on sociodemographics, clinical treatment, outcome measures on MUSE, and medication-nonadherence reasons. Results: The prevalence of poor medication understanding and use self-efficacy among stroke patients was 46.5%, of which 29.1% had poor “learning about medication” self-efficacy, while 36.2% lacked self-efficacy in taking medication. Beliefs about medicine (74.02%) was the commonest reason for medication nonadherence, followed by medication-management issues (44.8%). In the multivariate model, independent variables significantly associated with MUSE were health literacy (AOR 0.2, 95% CI 0.069-0.581; P=0.003), medication-management issues (AOR 0.073, 95% CI 0.020-0.266; P<0.001), multiple-medication issues (AOR 0.28, 95% CI 0.085-0.925; P=0.037), beliefs about medicine (AOR 0.131, 95% CI 0.032-0.542; P=0.005), and forgetfulness/convenience issues (AOR 0.173, 95% CI 0.050-0.600; P=0.006). Conclusion: The relatively poor learning about medication and medication-taking self-efficacy in this study was highly associated with health literacy and modifiable behavioral issues related to nonadherence, such as medication management, beliefs about medicine, and forgetfulness/ convenience. Further research ought to explore these underlying reasons using vigorous techniques to enhance medication understanding and use self-efficacy among stroke survivors to determine cause-effect relationships.
KW - Crosssectional
KW - Medication taking
KW - Medication understanding
KW - Poststroke
KW - Self-efficacy
UR - http://www.scopus.com/inward/record.url?scp=85073327313&partnerID=8YFLogxK
U2 - 10.2147/PPA.S215271
DO - 10.2147/PPA.S215271
M3 - Article
AN - SCOPUS:85073327313
SN - 1177-889X
VL - 13
SP - 1463
EP - 1475
JO - Patient Preference and Adherence
JF - Patient Preference and Adherence
ER -
