ORIGINAL ARTICLE: SOCIAL RESEARCH, PLANNING AND PRACTICE Medication use and adherence among multi-ethnic community- dwelling older adults in Malaysia Chin Fen Neoh, 1,2 Chiau Ming Long, 1,3 Siong Meng Lim, 1,2 Kalavathy Ramasamy, 1,2 Suzana Shahar 4 and Abu Bakar Abdul Majeed 1,3 1 Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, 2 Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences Community of Research, Universiti Teknologi MARA, 3 Brain Degeneration and Therapeutics Group, Pharmaceutical and Life Sciences Community of Research, Universiti Teknologi MARA, Shah Alam, Selangor and 4 Dietetic Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia Aim: The present study assessed adherence, barriers, belief and awareness towards the use of medications among multi- ethnic community-dwelling older adults in Malaysia. Medication accessibility, expenditure and perceptions towards med- icine labeling among older adults were also evaluated. Methods: A cross-sectional study was carried out in the central region of Malaysia from January to August 2015. The older adults enrolled in an ongoing prospective community-based geriatric cohort study and prescribed with medicines were interviewed using a 50-item validated questionnaire. Results: Of the 79 older adults interviewed, 39.2% had ≥4 prescribed medications. Most obtained their medications free-of-charge from government hospitals (66, 83.5%). Nearly half (35, 44.3%) had trouble reading labels for medicines that they had received. Chinese older adults (P = 0.001) and those with lower monthly household income (P < 0.001) expressed difficulty in reading medication labels. Most (59, 75.0%) were unable to differentiate between generic and brand names of the medications, and 49.4% of the older adults did not know that all medicines had to be registered with the Ministry of Health, Malaysia. Most older adults had positive beliefs about the necessity of their medications, and 50.6% (n = 40) reported high medication adherence. The medication adherence score was negatively correlated with the concerns score (r = –0.5, P < 0.001). Conclusions: The findings from the present study provide a unique insight into the diversity of medication use among multiethnic community-dwelling older adults. Although high adherence to medications and positive beliefs about the ne- cessity of medications were reported by the older adults, their knowledge about medications remained insufficient and they had difficulty in reading medication labels. Geriatr Gerontol Int 2016; ••: ••-••. Keywords: adherence, community, elderly, medicine, multi-ethnic. Introduction The use of multiple medications among older adults is very common in treating various body conditions, extend- ing life expectancy and improving quality of life. 1 Cognitive impairment and functional status decline in older adults, however, challenge their ability to adhere to complex medication regimens required to treat multiple medical problems. 2 As such, they are at risk of poor physical and emotional health outcomes. Poor adherence is considered a major public health problem, given its as- sociation with a high mortality of 125 000 deaths and substantial healthcare cost of approximately USD100 billion per year in the USA alone. 3 It is important to improve medicine-taking behaviour, as it might have a far greater impact on clinical outcomes than improvement in treatment. 4 Studies on medication use and adherence, in particular, among community-dwelling older people in both Asian and Malaysian settings, are limited. In addition, percep- tions towards medicine labeling, awareness towards appropriate use of medicine and beliefs about medication among community-dwelling Malaysian older people also remain unknown. Hence, the present study aimed to: (i) identify prescription and non-prescription medication Accepted for publication 22 May 2016. Correspondence: Dr Chin Fen Neoh BPharm (Hons), MClinPharm, PhD, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia. Email: neohchinfen@puncakalam.uitm.edu.my © 2016 Japan Geriatrics Society doi: 10.1111/ggi.12849 | 1 Geriatr Gerontol Int 2016