title: The influence of cultural and religious orientations on social support and its potential impact on medication adherence.
abstract: OBJECTIVE
  Social support can positively influence patients' health outcomes through a number of mechanisms, such as increases in patients' adherence to medication. Although there have been studies on the influence of social support on medication adherence, these studies were conducted in Western settings, not in Asian settings where cultural and religious orientations may be different. The objective of this study was to assess the effects of cultural orientation and religiosity on social support and its relation to patients' medication adherence.
  
  
  METHODS
  This was a cross-sectional study of patients with chronic diseases in two tertiary hospitals in Selangor, Malaysia. Patients who agreed to participate in the study were asked to answer questions in the following areas: 1) perceived group and higher authority cultural orientations; 2) religiosity: organizational and non-organizational religious activities, and intrinsic religiosity; 3) perceived social support; and 4) self-reported medication adherence. Patients' medication adherence was modeled using multiple logistic regressions, and only variables with a P-value of <0.25 were included in the analysis.
  
  
  RESULTS
  A total of 300 patients completed the questionnaire, with the exception of 40 participants who did not complete the cultural orientation question. The mean age of the patients was 57.6±13.5. Group cultural orientation, organizational religious activity, non-organizational religious activity, and intrinsic religiosity demonstrated significant associations with patients' perceived social support (r=0.181, P=0.003; r=0.230, P<0.001; r=0.135, P=0.019; and r=0.156, P=0.007, respectively). In the medication adherence model, only age, duration of treatment, organizational religious activity, and disease type (human immunodeficiency virus) were found to significantly influence patients' adherence to medications (adjusted odds ratio [OR] 1.05, P=0.002; OR 0.99, P=0.025; OR 1.19, P=0.038; and OR 9.08, P<0.05, respectively).
  
  
  CONCLUSIONS
  When examining religious practice and cultural orientation, social support was not found to have significant influence on patients' medication adherence. Only age, duration of treatment, organizational religious activity, and disease type (human immunodeficiency virus) had significant influence on patients' adherence.
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia.
authors.forename: Ernieda
authors.initials: E
authors.lastname: Hatah
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia ; Pharmacy Department, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur, Malaysia.
authors.forename: Kien Ping
authors.initials: KP
authors.lastname: Lim
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia.
authors.forename: Adliah Mohd
authors.initials: AM
authors.lastname: Ali
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia.
authors.forename: Noraida
authors.initials: N
authors.lastname: Mohamed Shah
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia.
authors.forename: Farida
authors.initials: F
authors.lastname: Islahudin
keywords: group orientation; power distance; religiosity