<p>Exploring stroke survivors’ self-efficacy in understanding and taking medication and determining associated factors: a cross-sectional study in a neurology clinic in Malaysia</p>

Abstract

Background and aimEvidence-based prescribing practices for stroke-preventive medication have benefited stroke survivors; however, medication-nonadherence rates remain high. Medication understanding and use self-efficacy (MUSE) has shown great importance in medication-taking behavior, but its relationship with medication nonadherence in stroke-preventive regimens lacks exploration. The aim of this study was to determine the prevalence of MUSE and its association with nonadherence causes and other potential factors among stroke survivors in Malaysia.MethodsThis cross-sectional study was conducted among 282 stroke patients who provided informed consent and were in follow-up at the Neurology Outpatient Department of Hospital Kuala Lumpur, Malaysia. The study employed a data-collection form that gathered information on sociodemographics, clinical treatment, outcome measures on MUSE, and medication-nonadherence reasons.ResultsThe prevalence of poor medication understanding and use self-efficacy among stroke patients was 46.5%, of which 29.1% had poor “learning about medication” self-efficacy, while 36.2% lacked self-efficacy in taking medication. Beliefs about medicine (74.02%) was the commonest reason for medication nonadherence, followed by medication-management issues (44.8%). In the multivariate model, independent variables significantly associated with MUSE were health literacy (AOR 0.2, 95% CI 0.069–0.581; P=0.003), medication-management issues (AOR 0.073, 95% CI 0.020-0.266; P<0.001), multiple-medication issues (AOR 0.28, 95% CI 0.085–0.925; P=0.037), beliefs about medicine (AOR 0.131, 95% CI 0.032–0.542; P=0.005), and forgetfulness/convenience issues (AOR 0.173, 95% CI 0.050–0.600; P=0.006).ConclusionThe relatively poor learning about medication and medication-taking self-efficacy in this study was highly associated with health literacy and modifiable behavioral issues related to nonadherence, such as medication management, beliefs about medicine, and forgetfulness/convenience. Further research ought to explore these underlying reasons using vigorous techniques to enhance medication understanding and use self-efficacy among stroke survivors to determine cause–effect relationships.

<p>An Evaluation of the Video Narrative Technique on the Self-Efficacy of Medication Understanding and Use Among Post-Stroke Patients: A Randomized-Controlled Trial</p>

“…Also, a previous work of ours in a similar patient population discovered that MUSE is positively associated with health literacy, illness perception, and treatment beliefs. 4 Hence, there was some evidence to elucidate the efficacy of the behavioral and motivational framework and use of media technology of this trial resulting in rapid improvements in SKT, BIPQ, and BMQ.…”

“…It was applied for three medication categories; antithrombotic, antihypertensive, and “all prescribed medication” to evaluate in-depth differences between these groupings. 24 Nevertheless, given that MUSE is closely linked to knowledge, perception, and belief of every individual, 4 secondary validated measures were necessary, to be able to understand the video narratives’ impact on modifiable dependent factors.…”

“…Furthermore, this trial well identified and adapted specific outcome measures, especially MUSE, which was also a potential predictor of medication adherence. 4 Nevertheless, this study has its limitations. More than 15% of the estimated attrition rate could have affected estimates of effect size for the intervention.…”

“…Furthermore, this trial well identified and adapted specific outcome measures, especially MUSE, which was also a potential predictor of medication adherence. 4 …”

“…2 Approximately 23% of stroke cases were stroke recurrence, and one of its contributing factors was treatment nonadherence. [2][3][4] Despite many efforts in the 'stroke and its risk factorpatient education innovation' revolving medication adherence, medication understanding, and taking behavioral issues remains a challenge for many healthcare professionals. It is because the health-related behavioral modification involves the individuals' and social perception towards their illness and its preventative measures.…”