Prevalence and determinants of medications non-adherence among patients with uncontrolled hypertension in primary care setting in Sarawak, Malaysia: A cross-sectional study

Hui Zhu Thew; Siew Mooi Ching; Hooi Min Lim; Mike Hitler Mos; Lorna Chin Kin Tze; Kui Feng Low; Nurdarlina Shaari; Jody Yii Sze Lin; Kai Wei Lee; Vasudevan Ramachandran

doi:10.51866/oa.182

Prevalence and determinants of medications non-adherence among patients with uncontrolled hypertension in primary care setting in Sarawak, Malaysia: A cross-sectional study

Malays Fam Physician. 2022 Oct 26;17(3):128-136. doi: 10.51866/oa.182. eCollection 2022 Nov 30.

Authors

Hui Zhu Thew¹, Siew Mooi Ching^{2

3

4}, Hooi Min Lim⁵, Mike Hitler Mos⁶, Lorna Chin Kin Tze⁷, Kui Feng Low⁸, Nurdarlina Shaari⁹, Jody Yii Sze Lin¹⁰, Kai Wei Lee¹¹, Vasudevan Ramachandran¹²

Affiliations

¹ MD (NNSMA), MMed (UPM), Department of Family Medicine, Faculty Medicine and Health Sciences, Serdang, Malaysia.
² MD (UNIMAS), MMed (UM), Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.
³ Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra, Malaysia, Serdang, Malaysia.
⁴ Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, 5 Jalan University, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
⁵ MBBS (UM), MMed (UM), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁶ MBBS (UM), Klinik Kesihatan Batu Kawa, Jalan Ensing Timur, Off Jalan, Stapok Utama,Kuching, Sarawak, Malaysia.
⁷ MD (UPM), MAFP, FRACGP, Klinik Kesihatan Miri, Jalan Merbau, Miri, Sarawak, Malaysia.
⁸ MD, Klinik Kesihatan Jalan Masjid, Jalan Masjid, Kuching, Sarawak, Malaysia.
⁹ MBBS(UM), MAFP, FRACGP, Klinik Kesihatan Telaga Air, Jalan Matang, Kuching, Sarawak, Malaysia.
¹⁰ MD (UNIMAS), MAFP, FRACGP, Klinik Kesihatan Tudan, Jalan Permyjaya, Miri, Sarawak, Malaysia.
¹¹ Ph.D. (UPM), Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra, Malaysia, Serdang, Malaysia.
¹² Ph.D. (UPM), Faculty of Health Sciences, University College MAIWP, International College, Taman Batu, Muda, Batu Caves, Kuala Lumpur, Malaysia.

PMID: 36606165
PMCID: PMC9809434
DOI: 10.51866/oa.182

Abstract

Introduction: Non-adherence to antihypertensive medications is a leading cause of uncontrolled hypertension and its complications. However, data on the factors associated with non-adherence to antihypertensive medications in the communities of Sarawak, Malaysia, are limited. This study aimed to examine the prevalence and determinants of medication non-adherence among patients with uncontrolled hypertension.

Method: A cross-sectional study was conducted using the systematic sampling method in four government primary healthcare clinics in Sarawak. A self-administered questionnaire was used to obtain socio-demographic data and evaluate non-adherence. Blood pressure was measured, and relevant clinical variables were collected from medical records. Multivariate logistic regression was used to determine the determinants of medication non-adherence.

Results: A total of 488 patients with uncontrolled hypertension were enrolled in this study. The prevalence of medication non-adherence was 39.3%. There were four predictors of medication non-adherence among the patients with uncontrolled hypertension: tertiary educational level (odds ratio [OR]=4.21, 95% confidence interval [CI] = 1.67-10.61, P=0.010), complementary alternative medication (0R=2.03, 95% CI=1.12-3.69, P=0.020), non-usage of calcium channel blockers (0R=1.57, 95% CI=1.02-2.41, P=0.039) and 1 mmHg increase in the systolic blood pressure (0R=1.03, 95% CI=1.00-1.05, P=0.006).

Conclusion: Because of the high prevalence of medication non-adherence among patients with uncontrolled hypertension, primary care physicians should be more vigilant in identifying those at risk of being non-adherent. Early intervention should be conducted to address non-adherence for blood pressure control.

Keywords: Hypertension; Malaysia; Patient compliance; Primary health care.