Background: Hypertension is one of the major risk factors of stroke and leading risk factors for global death. Inadequate control of blood pressure due to medication non-adherence remains a challenge and identifying the underlying causes will provide useful information to formulate suitable interventions. Purpose: This study aimed to explore the roles of culture, religiosity, and spirituality on adherence to anti-hypertensive medications. Methodology: A semi-structured qualitative interview was used to explore promoters and barriers to medication adherence among hypertensive individuals residing in urban and rural areas of Perak State, West Malaysia. Study participants were individuals who are able to comprehend either in Malay or English, above 18 years old and on antihypertensive medications. Interview transcriptions from 23 participants were coded inductively and analyzed thematically. Codes generated were verified by three co-investigators who were not involved in transcribing process. The codes were matched with quotations and categorized using three levels of themes named as organizing, classifying and general themes. Results: Cultural aspects categorized as societal and communication norms were related to nonadherence. The societal norms related to ignorance, belief in testimony and anything "natural is safe" affected medication adherence negatively. Communication norms manifested as superficiality, indirectness and non-confrontational were also linked to medication non-adherence. Internal and organizational religiosity was linked to increased motivation to take medication. In contrast, religious misconception about healing and treatment contributed towards medication nonadherence. The role of spirituality remains unclear and seemed to be understood as related to religiosity. Conclusion: Culture and religiosity (C/R) are highly regarded in many societies and shaped people's health belief and behaviour. Identifying the elements and mechanism through which C/ R impacted adherence would be useful to provide essential information for linking adherence assessment to the interventions that specifically address causes of medication non-adherence.
Anti-Drug Agency) in Telok Bahang were involved. The subjects were interviewed with WHOQOL BREF questionnaires before joining the MMT programme and also after minimum 4 months of joining MMT. Results obtained were used for comparing life style implications among methadone patients before and after joining the MMT programme. Subjects were predominantly of Malay ethnicity (82%). Subjects were mostly aged between 51 to 60 years old (34%). Paired t-test was done on the WHOQOL scores at baseline (before MMT) and after minimum of 4 months enrolment for all four domains. Each domain showed significant improvement in QOL (P < 0.05).The highest improvement was shown in the psychology domain with the mean value increment of 15.13 ± 17.49. Physical domain showed the least improvement with the mean value of 9.39 ± 16.21.This study has proven that MMT have highly contributed to improvement of quality of life among MMT clients in Klinik Kesihatan Bayan Lepas and AADK Telok Bahang.
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