"Strong medicine": Cambodian views of medicine and medical compliance.

OBJECTIVE

To identify important determinants of noncompliance among Cambodian refugees.

DESIGN

Open-ended interviews.

SETTING

University-affiliated ambulatory care clinic in an inner-city hospital.

PARTICIPANTS

Thirty adult Cambodian refugees (15 men and 15 women) who were regular utilizers of a refugee clinic.

MEASUREMENTS AND MAIN RESULTS

Sixty-seven percent of the participants described being noncompliant with at least one of their medications. Four common causes of noncompliance were identified: 1) misunderstanding the intent of the medication; 2) side effects; 3) concern about the effect of medication on "internal strength"; and 4) Cambodian ideas about pharmacokinetics.

CONCLUSIONS

Noncompliance was commonly reported by the Cambodian respondents. Noncompliance was both intentional and unintentional; the unintended noncompliance derived from patients' attempting to comply with therapy according to Cambodian ideas about the body and Western medication. This article suggests clinical approaches to enhance compliance with prescribed regimens among recent Cambodian immigrants and refugees.