Buathong Napakkawat, Naruephai Surawut, Wanichanon Worawit, Rodkitvitthaya Kananas, Thananinkul Peeraphol, Jankaew Napat, Wessamanon Phisit, Khaotrakul Samatchaya, Boonmak Ratthakorn, Choo-Eard Nichamon, Nintap Thanakrit, Sarakitphan Teera, Kaewchuay Paweeorn, Naruephai Kittiya, Chaison Monchai
Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Ban Koh Mak Sub-District Health Promoting Hospital, Phatthalung Province Administrative Organization, Phatthalung, Thailand.
BMJ Open. 2024 Dec 9;14(12):e089301. doi: 10.1136/bmjopen-2024-089301.
This study aimed to explore the prevalence of medication non-adherence and influence of symptom perception and various barriers on medication adherence among Thai Muslim patients in a rural subdistrict of southern Thailand.
Explanatory sequential mixed-methods approach.
A rural community in southern Thailand.
Data collection spanned from March to December 2023. In the quantitative phase, 138 Muslim patients diagnosed with non-communicable diseases were enrolled, and their medication adherence and associated factors were assessed. In the qualitative phase, 22 participants were selected for in-depth interviews, and their symptom perceptions and the obstacles they faced in adhering to medication were explored. A focus group discussion involving 10 healthcare workers from a subdistrict health-promoting hospital was conducted to gain insights into healthcare providers' perspectives on patients' perceptions of symptoms and barriers to medication adherence.
Medication non-adherence was assessed, and the influence of symptom perception and various barriers on medication adherence was evaluated RESULTS: The prevalence of medication non-adherence in the study sample was 75.36%. The following factors were significantly associated with medication non-adherence: occupation (farmer) (adjusted OR=3.93; 95% CI 1.04 to 12.64), lack of recommendations on adjusting medication schedules/dosages during Ramadan (adjusted OR=2.65; 95% CI 1.06 to 6.61) and patients' perception of no symptoms (adjusted OR=3.72; 95% CI 1.23 to 11.25). The qualitative analysis highlighted patient-related issues, such as lack of symptom perception, limited health literacy regarding disease information and treatment and personal reasons for non-adherence (eg, forgetfulness, occupational constraints and transportation challenges for medical appointments). Additionally, healthcare system-related factors, patient-doctor relationships and communication gaps in medication management during Ramadan were identified as factors influencing medication non-adherence.
To improve adherence, healthcare providers should prioritise fostering positive patient-provider relationships and promoting patient care through enhanced health literacy initiatives.
本研究旨在探讨泰国南部一个农村地区的泰国穆斯林患者中药物治疗不依从的患病率，以及症状感知和各种障碍对药物治疗依从性的影响。
解释性序列混合方法。
泰国南部的一个农村社区。
数据收集时间为2023年3月至12月。在定量阶段，招募了138名被诊断患有非传染性疾病的穆斯林患者，并评估了他们的药物治疗依从性及相关因素。在定性阶段，选择22名参与者进行深入访谈，探讨他们的症状感知以及在坚持服药方面面临的障碍。对来自一个分区促进健康医院的10名医护人员进行了焦点小组讨论，以深入了解医护人员对患者症状感知和药物治疗依从性障碍的看法。
评估药物治疗不依从情况，并评估症状感知和各种障碍对药物治疗依从性的影响。
研究样本中药物治疗不依从的患病率为75.36%。以下因素与药物治疗不依从显著相关：职业（农民）（调整后的比值比=3.93；95%置信区间1.04至12.64）、斋月期间缺乏调整药物时间表/剂量的建议（调整后的比值比=2.65；95%置信区间1.06至6.61）以及患者无症状感知（调整后的比值比=3.72；95%置信区间1.23至11.25）。定性分析突出了与患者相关的问题，如缺乏症状感知、对疾病信息和治疗的健康素养有限以及不依从的个人原因（如健忘、职业限制和就医的交通挑战）。此外，还确定了与医疗系统相关的因素、医患关系以及斋月期间药物管理中的沟通差距是影响药物治疗不依从的因素。
为了提高依从性，医疗服务提供者应优先通过加强健康素养倡议来培养积极的医患关系并促进患者护理。
