Men’s health: Importance of regular health screening, medication adherence among Malaysians

KUALA LUMPUR, May 29 – In a world now affected by many non-communicable diseases, there is a need to encourage both genders to go for screening for diseases such as hypertension, diabetes and hyperlipidaemia and subsequently adhering to the treatment plan.

Compliance with medication is of great importance, for failing to comply can result in the failure of even the most effective treatment.

This non-compliance rate can number up to 50 per cent, according to the literatures available independent of any of the many compliance scales used.

Many factors can affect non-compliance

These include demographic factors such as income, education and social support, therapy-related factors such as complicated dosage regimens and adverse drug reactions, health-care system factors such as medication costs, patient-provider relationship and patient-related factors such as attitudes toward drugs and treatment beliefs.

Patient non-compliance can often lead to significantly increased costs to already highly government subsided healthcare system that otherwise could have been channelled to the nation’s other developmental needs.

Many studies have in turn shown that there may be gender differences in health behaviours and beliefs as well as health and compliance in taking medications.

According to the literature, poor adherence appears to be associated more with women than with men although differing results have been described.

In a large study in Ireland, 23 per cent of men, or one in four, reported non-compliance to medications.

There were many reasons for non-compliance in this study

These included simple forgetfulness, worried about side effects and effectiveness of the medications, and patient perception that they don’t need the medication anymore.

The most common barriers to compliance were the thought that the treatment does not make a difference nor it will prevent further deterioration of their condition.

Men also have differences in screening preferences as compared to women.

In some countries where prostate-specific antigen (PSA) is offered as a screening test, the difference in preferences exists in where men that are more health-conscious and worried about missing the diagnosis of prostate cancer tend to go for PSA testing as compared to men who are more worried about over-diagnosis and over-treatment, and are well-versed with the knowledge that prostate cancer mostly remains indolent.

The challenge remains in aiding men to improve their compliance to medication as well as to go for evidence-based screening tests such as colorectal cancer screening and screening for non-communicable diseases.

Recommended strategies to increase compliance include more patient education, allowing more time for a physician to spend with their patients as well as reminders such as alarm clock and diary to remind the patient on adhering to their medication.

To aid screening, understanding important terms such as true positive, false positive, true negative, as well as sensitivity and specificity are crucial.

As such, decision aids can help increase the decision-making skills of the patients in understanding the benefits and harms in undergoing screening and the presence of any alternative choices.

Equally important is incorporating a patient’s own values and preferences in aiding decisions to go for screening.

Noting these challenges, young physicians should equip themselves with adequate communication and clinical skills to be able to offer evidence-based advice to men in regards to going for screening and adhering to medications.

The Men’s Health World Congress (MHWC), which was slated to take place at the Borneo Convention Centre in Sarawak in July, has been postponed to next year from October 7 to 9 due to the developments of the Covid-19 situation.

“It has been a very difficult decision for the organising committee as we have assembled a team of world-class faculty members in this very exciting congress.

“However, your safety is of the utmost importance and in the best interests of everyone, we have decided to postpone the MHWC,” said the organiser in a statement.

The organiser also said the venue will remain unchanged.

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* Dr Navin Kumar Devaraj holds a Master of Medicine in Family Medicine from University of Malaya since 2016. He is a family medicine specialist and medical lecturer with Universiti Putra Malaysia (UPM) Medicine and Health Sciences Faculty. Dr Abdul Hadi Abdul Manap is also a clinical lecturer with UPM Family Medicine Department and is a member with the Family Medicine Specialist Association.