Factors associated with persistent medication non-adherence in ethnic patients with chronic disease at the Subdistrict Health Promotion Hospital, Mae Chaem District, Chiang Mai Province
Keywords:
Medication adherence, Ethnic minorities, Healthcare accessibilityAbstract
Background Ethnic minority patients with chronic diseases in remote areas such as Mae Chaem District, Chiang Mai Province, face multiple barriers to continuous medication use, including sociocultural factors, language difficulties, and limited healthcare access, all of which directly affect clinical outcomes.
Methods A descriptive cross-sectional study was conducted among 180 ethnic patients with chronic diseases between May and October 2025. Multi-stage random sampling was employed. Medication adherence was assessed using the TMARS and TMARS-VAS scales. Data were analyzed using Chi-square/Fisher's Exact Test and Multiple Logistic Regression.
Results Most participants were of Karen ethnicity (56.11%), engaged in agriculture, and earned below 10,000 baht per month. The most common non-adherent behaviors were forgetting doses (38.3%) and taking medication late (32.8%). Significant associated factors included ethnicity, religion, occupation, marital status, disease type, number of medications, illness duration, distance, transportation, herbal medicine beliefs, and Thai language proficiency.
Conclusion Distance from home to hospital was the sole statistically significant predictor of non-adherence. Patients living more than 10 kilometers away were 4.62 times more likely to be non-adherent than those within 5 kilometers (Adjusted OR = 4.62, 95% CI = 1.85–11.57, p = 0.001), indicating that structural barriers outweigh individual factors.
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