Abstract
Medication adherence is crucial for managing the progression of chronic non communicable diseases among patients. Promoting medication adherence at the operational level serves as a significant mechanism for both treatment and enhancing patients' quality of life. This research employed a mixed method approach, beginning with qualitative data collection through in depth interviews involving 11 patients with chronic non communicable diseases and 12 healthcare personnel. The findings then served as a conceptual framework for the subsequent quantitative research. Quantitative data were collected via questionnaires distributed to 76 healthcare personnel working in the Non communicable chronic disease NCD) clinic of a community hospital and primary service units within the network The research findings indicated that patients perceived journey through the service process as having five steps: 1) registration, blood examination, and blood pressure measurement; 2) waiting for the examination; 3) receiving treatment; 4) waiting for medication; and 5) receiving medication. Conversely, healthcare professionals perceived their role during the examination waiting period and medicine waiting period as involving health assessment services, addressing disease complications, and health education to improve patient self care behaviors The health service systems related to patients with chronic non communicable diseases lacked clear guidelines for promoting medication adherence. Healthcare personnel, however, actively engaged in promoting medication adherence across three areas: 1) assessing medication adherence, 2) communication for effective treatment, and 3) clinical decision making to support adherence Various factors and conditions influencing medication adherence, categorized into three areas: patient factors, personnel factors, and system factors The study of healthcare providers' promotion of medication adherence revealed that they practiced the most in communication for effective treatment, whereas assessing medication adherence received the least attention. Operation through communication for effective treatment was robust across all dimensions Fill Refill, Understand, Organize, Take, Monitor, and Sustain). On the other hand, assessing medication was moderately rated, and overall clinical decision making scores was high. Notably, Take’ was the most assessed dimension, while Organize’ was the least assessed. Communication was highest in the dimension of Fill refill’’, while the Understand dimension received the least attention. Clinical decision making to promote medication adherence was highest in the dimension of Understand’ dimension and lowest in the Fill refill’ dimension The analysis of the relationships between personal factors, patient condition factors, healthcare personnel factors, and system factors with the promotion of medication adherence, utilizing Point biserial correlation statistics and Spearman's rank correlation statistics, indicated several significant relationships. Notably, related training exhibited a significant relationship (rpb = .32, p < .01). Patient factors, including the feature of medications (rs = .21, p < .05) and the patient's self care potential (rs = .24, p < .05), as well as healthcare personnel factors, particularly personnel's understanding of disease, medication, and adherence (rs = .24, p < .05), demonstrated statistically significant relationships with the promotion of medication adherence
