The latest Malaysia National Health and Morbidity Survey 2019 (NHMS 2019) shows that 6.4 million people in Malaysia have hypertension. Despite the availability of effective treatment for hypertension, among 90% of them were on medication, 45% of the patients did not comply with the prescribed medications.
Medication non-compliance is strongly related to hospital admission, increases healthcare costs, indirectly reduces the quality of life, and wastes healthcare resources. A patient not complying with the prescribed medication is consistently not being noticed by the patient, their families and healthcare provider. The non-compliance problem does not appear on a patient's death certificate who has died of a stroke after not taking his antihypertensive medication. Consequently, poor compliance receives little direct and systematic intervention.
However, compliance is a complex behavioural process that is strongly influenced by the environment in which the patient lives and the psychological and social support system. Many patients have a strong negative perception of conventional medicine by expressing terms such as unnatural, harmful, addictive, adverse effects, dependence and ineffective, leading patients to avoid receiving prescribed medicine. In a recent Malaysian study, patients with high blood pressure recorded a high number (62.6%) of complementary and alternative medicine (CAM) usage. Therefore, tackling hypertensive non-compliance issues with multifaceted strategies is essential for healthcare providers (HCPs) to maintain patient outcome quality.
Suggested intervention strategies for HCPs
HCPs should empower patients with the necessary information regarding prescribed medicine and allow them to use it in conjunction with CAM. By encouraging patients to share their knowledge about using CAM, HCPs could identify CAM products or practices that are safe for the patient and will not counteract the prescribed medicine.
With the primary goal being to help the patient to comply better to the medicine, HCPs are required to teach patients and their caregivers about hypertension self-care as follows:
Furthermore, HCPs also play an important role in improving and sustaining compliance. Several steps have been formulated, which include:
Finally, all practical interventions reported here have limitations. The most important concepts in health care are teamwork and the spirit of collaboration. HCPs must plan, coordinate and negotiate with relevant medical staff regarding the goal of the treatment needed by the patient.
NAMA Lee Khuan (Prof. Madya Dr.)
JAWATAN Pensyarah Profesor Madya
Jabatan Department of Nursing Fakulti Faculty of Medicine and Health Sciences Universiti Putra Malaysia Selangor Malaysia
KEPAKARAN KEJURURAWATAN (PERIOPERATIF & KESIHATAN KOMUNITI)
EMEL leekhuan@upm.edu.my
TELEFON +603 9769 2438
Tarikh Input: 31/12/2021 | Kemaskini: 31/12/2021 | mukhriz
Pejabat Am Dekan
Aras 3, Bangunan Pentadbiran,
Fakulti Perubatan dan Sains Kesihatan,
43400 UPM Serdang, Selangor Darul Ehsan.