Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study
Background: Poor medication adherence can lead to adverse health outcomes and increased healthcare costs. Although reasons for medication adherence have been widely studied, less is explored about factors affecting medication adherence for patients in non-Western healthcare setting and from Asian cu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1124297/full |
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| author | Sungwon Yoon Sungwon Yoon Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Wei Liang Yap Zhui Ying Lim Jie Kie Phang Jie Kie Phang Yu Xian Loo Junjie Aw Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low |
| author_facet | Sungwon Yoon Sungwon Yoon Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Wei Liang Yap Zhui Ying Lim Jie Kie Phang Jie Kie Phang Yu Xian Loo Junjie Aw Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low |
| author_sort | Sungwon Yoon |
| collection | DOAJ |
| description | Background: Poor medication adherence can lead to adverse health outcomes and increased healthcare costs. Although reasons for medication adherence have been widely studied, less is explored about factors affecting medication adherence for patients in non-Western healthcare setting and from Asian cultures. This study aimed to explore cultural perspectives on factors influencing medication adherence among patients with chronic diseases in a multi-ethnic Asian healthcare setting.Methods: We conducted a qualitative study involving in-depth interviews with patients with chronic conditions purposively recruited from a community hospital in Singapore until data saturation was achieved. A total of 25 patients participated in this study. Interviews were transcribed and thematically analyzed. Themes were subsequently mapped into the World Health Organization (WHO) Framework of Medication Adherence.Results: Participants commonly perceived that sides effects (therapy-related dimension), poor understanding of medication (patient-related dimension), limited knowledge of condition (patient-related dimension), forgetfulness (patient-related dimension) and language issues within a multi-ethnic healthcare context (healthcare team and system-related dimension) as the main factors contributing to medication adherence. Importantly, medication adherence was influenced by cultural beliefs such as the notion of modern medicines as harms and fatalistic orientations towards escalation of doses and polypharmacy (patient-related dimension). Participants made various suggestions to foster adherence, including improved patient-physician communication, enhanced care coordination across providers, use of language familiar to patients, patient education and empowerment on the benefits of medication and medication adjustment.Conclusion: A wide range of factors influenced medication adherence, with therapy- and patient-related dimensions more pronounced compared to other dimensions. Findings demonstrated the importance of cultural beliefs that may influence medication adherence. Future efforts to improve medication adherence should consider a person-centered approach to foster more positive health expectations and self-efficacy on medication adherence, supplemented with routine reviews, development of pictograms and cultural competence training for healthcare professionals. |
| first_indexed | 2024-04-10T05:12:37Z |
| format | Article |
| id | doaj.art-5ce5fa84bde544b0bc4f505ecfe76836 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-10T05:12:37Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-5ce5fa84bde544b0bc4f505ecfe768362023-03-09T07:02:43ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-03-011410.3389/fphar.2023.11242971124297Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative studySungwon Yoon0Sungwon Yoon1Yu Heng Kwan2Yu Heng Kwan3Yu Heng Kwan4Yu Heng Kwan5Wei Liang Yap6Zhui Ying Lim7Jie Kie Phang8Jie Kie Phang9Yu Xian Loo10Junjie Aw11Lian Leng Low12Lian Leng Low13Lian Leng Low14Lian Leng Low15Lian Leng Low16Lian Leng Low17Health Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, SingaporeHealth Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, SingaporeDepartment of Pharmacy, National University of Singapore, Singapore, SingaporeDepartment of Internal Medicine, Singapore Health Services, Singapore, SingaporeDuke-NUS Medical School, Singapore, SingaporePopulation Health and Integrated Care Office (PHICO), Singapore General Hospital, Singapore, SingaporeHealth Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, SingaporePost-Acute and Continuing Care, Outram Community Hospital, Singapore, SingaporePost-Acute and Continuing Care, Outram Community Hospital, Singapore, SingaporeHealth Services and Systems Research, Duke-NUS Medical School, Singapore, SingaporeCentre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, SingaporePopulation Health and Integrated Care Office (PHICO), Singapore General Hospital, Singapore, SingaporePost-Acute and Continuing Care, Outram Community Hospital, Singapore, SingaporeDepartment of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, SingaporeSingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore, SingaporeBackground: Poor medication adherence can lead to adverse health outcomes and increased healthcare costs. Although reasons for medication adherence have been widely studied, less is explored about factors affecting medication adherence for patients in non-Western healthcare setting and from Asian cultures. This study aimed to explore cultural perspectives on factors influencing medication adherence among patients with chronic diseases in a multi-ethnic Asian healthcare setting.Methods: We conducted a qualitative study involving in-depth interviews with patients with chronic conditions purposively recruited from a community hospital in Singapore until data saturation was achieved. A total of 25 patients participated in this study. Interviews were transcribed and thematically analyzed. Themes were subsequently mapped into the World Health Organization (WHO) Framework of Medication Adherence.Results: Participants commonly perceived that sides effects (therapy-related dimension), poor understanding of medication (patient-related dimension), limited knowledge of condition (patient-related dimension), forgetfulness (patient-related dimension) and language issues within a multi-ethnic healthcare context (healthcare team and system-related dimension) as the main factors contributing to medication adherence. Importantly, medication adherence was influenced by cultural beliefs such as the notion of modern medicines as harms and fatalistic orientations towards escalation of doses and polypharmacy (patient-related dimension). Participants made various suggestions to foster adherence, including improved patient-physician communication, enhanced care coordination across providers, use of language familiar to patients, patient education and empowerment on the benefits of medication and medication adjustment.Conclusion: A wide range of factors influenced medication adherence, with therapy- and patient-related dimensions more pronounced compared to other dimensions. Findings demonstrated the importance of cultural beliefs that may influence medication adherence. Future efforts to improve medication adherence should consider a person-centered approach to foster more positive health expectations and self-efficacy on medication adherence, supplemented with routine reviews, development of pictograms and cultural competence training for healthcare professionals.https://www.frontiersin.org/articles/10.3389/fphar.2023.1124297/fullmedication adherencechronic diseaseAsian patientsmulti-ethnic settingWHO framework |
| spellingShingle | Sungwon Yoon Sungwon Yoon Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Yu Heng Kwan Wei Liang Yap Zhui Ying Lim Jie Kie Phang Jie Kie Phang Yu Xian Loo Junjie Aw Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Lian Leng Low Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study Frontiers in Pharmacology medication adherence chronic disease Asian patients multi-ethnic setting WHO framework |
| title | Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study |
| title_full | Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study |
| title_fullStr | Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study |
| title_full_unstemmed | Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study |
| title_short | Factors influencing medication adherence in multi-ethnic Asian patients with chronic diseases in Singapore: A qualitative study |
| title_sort | factors influencing medication adherence in multi ethnic asian patients with chronic diseases in singapore a qualitative study |
| topic | medication adherence chronic disease Asian patients multi-ethnic setting WHO framework |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1124297/full |
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