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

Figures & data

Table 1 Sociodemographics and health information of patients with stroke (n=282)

	n (%)
Sex
Male	189 (67)
Female	93 (33)
Age-group (years)
≥60	123 (43.6)
40–59	137 (48.6)
≤39	22 (7.8)
Mean ± SD	57±12
Ethnicity
Malay	155 (55)
Chinese	46 (16.3)
Indian	74 (26.2)
Other	7 (2.5)
Education level
Primary	67 (23.8)
Secondary	156 (55.3)
Tertiary	55 (19.5)
None	4 (1.4)
Health-literacy
Adequate	182 (64.5)
Limited	100 (35.5)
Type of stroke
Ischemic	188 (66.7)
Hemorrhagic	7 (2.5)
Transient ischemic attack	87 (30.9)
Stroke risk (comorbidities)
Hypertension and other risks*	274 (97.2)
Diabetes only	8 (2.8)
Types of prescribed medication
≤2 types	23 (8.2)
≥3 types	259 (91.8)
Exposure to stroke and preventive information
Yes	221 (78.4)
No	61 (21.6)

Notes: *Inclusive of one, two, or more stroke-risk factors, eg, diabetes, hyperlipidemia, atrial fibrillation.

Table 2 Association of sociodemographics, stroke treatment, and medication-nonadherence reasons with Medication Understanding and Use Self-Efficacy Scale (MUSE) scores

	Poor MUSE, n (%)	Good MUSE, n (%)	OR	95% CI	P-value	Cramer’s V
Sex
Male	89 (47.1)	100 (52.9)	1.08	0.66–1.78	0.760	0.018
Female	42 (45.2)	51 (54.8)
Age-group (years)
≥60	64 (52.0)	59 (48.0)	1.49	0.93–2.39	0.099	0.098
≤59	67 (42.1)	92 (57.9)
Health literacy
Limited	65 (65.0)	35 (35.0)
Adequate	66 (36.3)	116 (63.7)	0.31*	0.18–0.51	<0.001*	0.276^a,*
Medication
≤2 types	11 (47.8)	12 (52.2)	1.06	0.45–2.49	0.890	0.008
≥3 types	120 (46.3)	139 (53.7)
Blood pressure
Controlled	35 (42.2)	48 (57.8)	0.78	0.46–1.29	0.320	0.060
Uncontrolled	93 (48.7)	98 (51.3)
Stroke education
Yes	96 (43.4)	125 (56.6)	0.57	0.32–1.01	0.053	0.115
No	35 (57.4)	26 (42.6)
Medication-nonadherence reasons
Management issues
Yes	58 (84.1)	11 (15.9)
No	73 (34.3)	140 (65.7)	0.10*	0.05–0.20	<0.001*	0.429^a,*
Multiple-medication issues
Yes	44 (73.3)	16 (26.7)
No	87 (39.2)	135 (60.8)	0.23*	0.13–0.44	<0.001*	0.280^a,*
Beliefs about medications
Yes	80 (70.2)	34 (29.8)
No	51 (30.4)	117 (69.6)	0.19*	0.11–0.31	<0.001*	0.392^a,*
Forgetfulness and convenience issues
Yes	46 (74.2)	16 (25.8)
No	85 (38.6)	135 (61.4)	0.22*	0.12–0.41	<0.001*	0.295^a,*
Medication adherence
Good	22 (16.9)	108 (83.1)
Poor	109 (71.7)	43 (28.3)	12.44*	6.98–22.19	<0.001*	0.548*

Notes: Pearson Chi Square test, *Statistically significant, ^aPhi (negative).

Table 3 Factors associated with Medication Understanding and Use Self-efficacy Scale using multinomial logistic regression analyses

Independent variables	Coefficient	P-value	AOR	95% CI
Both LM and TM poor
Age
≥60 years	0.135	0.797	1.144	0.411–3.189
≤59 years^b
Sex
Male	0.872	0.124	2.392	0.787–7.277
Female^b
Health literacy
Adequate	−1.610	0.003*	0.200	0.069–0.581
Limited^b
Medication quantity
≤2 types	0.175	0.879	1.192	0.124–11.452
≥3 types^b
Blood pressure
Controlled	−0.900	0.157	0.406	0.117–1.413
Uncontrolled^b
Stroke education
Yes	−0.062	0.918	0.940	0.290–3.047
No^b
Medication-management issues
No	−2.615	0.000*	0.073	0.020–0.266
Yes^b
Multiple-medication issues
No	−1.273	0.037*	0.280	0.085–0.925
Yes^b
Beliefs about medication issues
No	−2.033	0.005*	0.131	0.032–0.542
Yes^b
Forgetfulness/convenience issues
No	−1.755	0.006*	0.173	0.050–0.600
Yes^b
Either LM or TM poor
Age
≥60 years	−0.206	0.518	0.814	0.435–1.521
≤59 years^b
Sex
Male	0.136	0.676	1.145	0.605–2.167
Female^b
Health literacy
Adequate	−0.423	0.221	0.655	0.333–1.290
Limited^b
Medication quantity
≤2 types	1.022	0.125	2.779	0.752–10.266
≥3 types^b
Blood pressure
Controlled	−0.171	0.606	0.843	0.441–1.612
Uncontrolled^b
Stroke education
Yes	−0.087	0.826	0.917	0.423–1.987
No^b
Medication-management issues
No	−1.988	0*	0.137	0.056–0.334
Yes^b
Multiple-medication issues
No	−0.137	0.767	0.872	0.351–2.162
Yes^b
Beliefs about medication issues
No	−0.090	0.819	0.914	0.422–1.979
Yes^b
Forgetfulness/convenience issues
No	−1.003	0.025*	0.367	0.153–0.881
Yes^b

Notes: The reference category is both LM and TM good; ^breference group; *statistically significant.

Abbreviations: LM, learningabout medicine; TM, takingmedication.