Exploring symptoms perception and barriers to medication adherence among Thai Muslim patients with non-communicable diseases in a rural community in southern Thailand: a mixed-methods study

Abstract

Objectives This study aimed to explore the prevalence of medication non-adherence and influence of symptom perception and various barriers on medication adherence among Thai Muslim patients in a rural subdistrict of southern Thailand.Design Explanatory sequential mixed-methods approach.Setting A rural community in southern Thailand.Methods Data collection spanned from March to December 2023. In the quantitative phase, 138 Muslim patients diagnosed with non-communicable diseases were enrolled, and their medication adherence and associated factors were assessed. In the qualitative phase, 22 participants were selected for in-depth interviews, and their symptom perceptions and the obstacles they faced in adhering to medication were explored. A focus group discussion involving 10 healthcare workers from a subdistrict health-promoting hospital was conducted to gain insights into healthcare providers’ perspectives on patients’ perceptions of symptoms and barriers to medication adherence.Outcome measures Medication non-adherence was assessed, and the influence of symptom perception and various barriers on medication adherence was evaluatedResults The prevalence of medication non-adherence in the study sample was 75.36%. The following factors were significantly associated with medication non-adherence: occupation (farmer) (adjusted OR=3.93; 95% CI 1.04 to 12.64), lack of recommendations on adjusting medication schedules/dosages during Ramadan (adjusted OR=2.65; 95% CI 1.06 to 6.61) and patients’ perception of no symptoms (adjusted OR=3.72; 95% CI 1.23 to 11.25). The qualitative analysis highlighted patient-related issues, such as lack of symptom perception, limited health literacy regarding disease information and treatment and personal reasons for non-adherence (eg, forgetfulness, occupational constraints and transportation challenges for medical appointments). Additionally, healthcare system-related factors, patient–doctor relationships and communication gaps in medication management during Ramadan were identified as factors influencing medication non-adherence.Conclusions To improve adherence, healthcare providers should prioritise fostering positive patient–provider relationships and promoting patient care through enhanced health literacy initiatives.