Cam Use In Non-Compliance Hypertensive Patient And Intervention Strategies For HCPs | FAKULTI PERUBATAN DAN SAINS KESIHATAN
» ARTIKEL » Cam Use In Non-Compliance Hypertensive Patient And Intervention Strategies For HCPs

Cam Use In Non-Compliance Hypertensive Patient And Intervention Strategies For HCPs

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:

 

  • To measure and monitor BP to assess their own compliance. If the BP measurement facility is unavailable, they can always go to the nearby GP or public clinic.
  • To understand the importance of maintaining BP controls every day, taking medicine, and not relying on physical symptoms.
  • To learn how to deal with missing doses, how to recognise side effects and what to do if they encounter side effects.

 

Furthermore, HCPs also play an important role in improving and sustaining compliance. Several steps have been formulated, which include:

 

  • Maintaining and building a good relationship with the patient during medical encounters, insist on patient-centred care.
  • Use non-threatening questions to assess the extent of compliance in patients.
  • Ask about and explore the experience of side effects from the prescribed medicine and how they affect their quality of life.
  • Ask and listen to the patient concerning using any alternative medicine besides the prescribed medicine.
  • Investigate patients’ use of CAM, educate patients about not using CAM that counteracts the current use of prescribed medicine and empowers patients with informed choices in selecting medicine.
  • Record the patient’s use of CAM and encourage them to express their experiences in using CAM.
  • Educate patients with a basic understanding of hypertension, the prescribed medicine's function and the importance of compliance, anticipated side effects, and strategies to deal with them.
  • Respect the methods used by patients in setting cues to take medicine, when necessary, assist patients in taking medicine by setting up reminders, such as detailed schedules, integrate with daily habits, use medicine dispensing box, timer, alarms, and beepers.
  • Encourage family members to remind and coach the patient to take their medicine regularly.
  • Encourage self-management and allow patients to have control and make decisions collaboratively with health professionals.

 

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

PERKONGSIAN MEDIA

FAKULTI PERUBATAN DAN SAINS KESIHATAN
Universiti Putra Malaysia
43400 UPM Serdang
Selangor Darul Ehsan
03 9769 2300
03 9769 2585
SXDdPAm~