EMERGENCY DEPARTMENT VISIT DUE TO MEDICATION NON-ADHERENCE AT A TEACHING HOSPITAL IN MALAYSIA

Background: Medication non-adherence is a growing burden to the health care system in Malaysia.  Aim: The study aimed to determine the prevalence, severity, outcome, and factors associated with emergency department (ED) visit due to medication non-adherence at a teaching hospital in Malaysia. Methods: A cross-sectional study design was conducted on patients at the ED of Hospital Universiti Sains Malaysia over six weeks from December 2014 to January 2015. Data were collected using patient interview and review of patient’s medical records. Statistical analysis: Descriptive statistics and multiple logistic regression. Results: Out of the 434 patients on ED visit, 63 (14.5%) [95%CI, 11.0%, 18.0%] were related to medication non-adherence, out of which, 53 (84.1%) experienced severe outcome of the ED visit, 48 (76.2%) were admitted to the ED observation ward, 10 (15.9%) to the hospital ward and 5 (7.9%) were discharged immediately after they have consulted with the ED-physician. Factors associated with the ED visit due to medication non-adherence were: cardiovascular disorder [OR: 7.5 (95%CI 5.3, 11.0)], tuberculosis [OR: 5.5 (95% CI 2.8, 10.6)], asthma [OR: 2.6 (95% CI, 1.7, 4.4)], diabetes mellitus (type II) [OR: 0.2 (95%CI, 0.1, 0.4)], central nervous system disorder [OR: 3.8 (95% CI, 2.2, 5.6)] and consulting multiple prescribers [OR: 0.4 (95%CI, 0.2, 0.8)]. Conclusion: Medication non-adherence is a significant contributor to ED visit, especially among patients with chronic illnesses in Malaysia. More intervention measures should be focused on people with chronic diseases.