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Perspectives of heart failure patients in Malaysia towards medications and disease state management: findings from a qualitative study

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Abstract

Aim

This study aimed to explore the experiences of readmitted heart failure (HF) patients towards managing their medical problems and to identify factors influencing their adherence to medications.

Subject and methods

A qualitative exploratory study was conducted among HF patients who were admitted to Penang General Hospital, Malaysia. A purposive sample of 15 male and 5 female patients of various ethnic groups were interviewed using a semi-structured interview guide. The interviews were audiotaped and transcribed verbatim for thematic content analysis.

Results

The interviewed patients were generally disturbed by the deterioration in physiological function due to HF. They were aware of the importance of taking HF medications and control of fluid intake but not sodium intake. However, the participants still needed more clarification on ways to reduce sodium intake and improve adherence to lifelong medications and diet. The respondents identified individualized patient self-care, disease, and medication counseling that empower patients to monitor their own body condition to enhance adherence. Barriers identified were limited communication with health care practitioners, lack of correct information about medications and HF, difficulty in remembering, complexity of regimens, and lack of compelling HF symptoms.

Conclusion

The present study has identified empowerment of patients in decision making as the main facilitator to improve adherence. These findings suggest that there is a need for doctors and pharmacists to broaden their involvement in exploring and shaping individual patient’s beliefs regarding HF and its management in order to achieve successful treatment outcomes.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia

    Long Chiau Ming

  2. Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia

    Mohamed Azmi Hassali, Asrul Akmal Shafie, Ahmed Awaisu & Mahmoud Al-Haddad

  3. School of Healthcare, Faculty of Medicine and Health, University of Leeds, LS2 9UT, Leeds, UK

    Muhammad Abdul Hadi

Authors
  1. Long Chiau Ming
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  2. Mohamed Azmi Hassali
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  3. Asrul Akmal Shafie
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  4. Ahmed Awaisu
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  5. Muhammad Abdul Hadi
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  6. Mahmoud Al-Haddad
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Corresponding author

Correspondence to Mohamed Azmi Hassali.

Appendix 1: Themes identified

Appendix 1: Themes identified

1.0 Impact of disease on daily life

1.1 Impact on daily routine and quality of life (QOL)

1.2 Impact on work/career

2.0 Perception and knowledge of the roles of medicine in controlling HF

2.1 Knowledge on importance of taking medication

2.2 Difficulty faced by the participant in taking lifelong medications

2.3 Issues related to side effects

2.4 Information needs on adverse drug reaction of medication

3.0 Control of fluid and salt intakes

3.1 Measure taken to control fluid intake

3.2 Difficulty in controlling fluid intake

4.0 Facilitators to enhance adherence

4.1 Understanding symptoms of HF, perceiving physical symptoms, and recognizing those symptoms as symptoms of HF

4.2 Effectiveness of the drugs

4.3 The desire to survive

4.4 Supportive family and reassurance on benefit of medicine by health care practitioner

4.5 Preference for modern medicine versus traditional medicine

4.6 Habitual routine and location of medications

5.0 Barriers to enhance adherence

5.1 Limited communication with health care practitioners

5.2 Lack of correct information about medications and HF

5.3 Difficulty in remembering

5.4 Complexity of regimens

5.5 Lack of compelling symptoms

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Ming, L.C., Hassali, M.A., Shafie, A.A. et al. Perspectives of heart failure patients in Malaysia towards medications and disease state management: findings from a qualitative study. J Public Health 19, 569–577 (2011). https://doi.org/10.1007/s10389-011-0415-5

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  • DOI: https://doi.org/10.1007/s10389-011-0415-5

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