Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics
BackgroundMultimorbidity, the coexistence of two or more chronic conditions, is increasingly prevalent in Jordan, a middle-income country with a growing non-communicable disease (NCD) burden and limited data on medication adherence. This study examined adherence prevalence, predictors, and barriers...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1619023/full |
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| author | Anas Abed Mohammad Abu Assab Wael Abu Dayyih Badriyah S. Alotaibi Nawal Alsubaie |
| author_facet | Anas Abed Mohammad Abu Assab Wael Abu Dayyih Badriyah S. Alotaibi Nawal Alsubaie |
| author_sort | Anas Abed |
| collection | DOAJ |
| description | BackgroundMultimorbidity, the coexistence of two or more chronic conditions, is increasingly prevalent in Jordan, a middle-income country with a growing non-communicable disease (NCD) burden and limited data on medication adherence. This study examined adherence prevalence, predictors, and barriers among Jordanians with multimorbidity to inform interventions supporting Sustainable Development Goal 3.MethodsA cross-sectional, mixed-methods study was conducted from April to December 2024 in two tertiary Hospitals’ outpatient clinics in Amman. Adults (≥18 years) with ≥2 chronic conditions requiring ongoing medication (n = 405) were recruited via convenience sampling. Adherence was assessed using the General Medication Adherence Scale (GMAS, 0–33; high adherence defined as GMAS ≥27) alongside a Self-Administered Comorbidity Questionnaire (SCQ)-like checklist. Qualitative data were collected through an open-ended question and analyzed using thematic analysis. Descriptive statistics, correlation analysis, and logistic regression were used. Qualitative data were analysed using thematic analysis.ResultsOf 420 invited participants, 405 completed the survey (response rate: 96.4%). High adherence (GMAS ≥27) was observed in 54.3% of participants. Factors positively associated with medication adherence included older age, higher income, fewer medications, higher health literacy, and social support, while cost, polypharmacy, forgetfulness, rural residence, and low perceived medication necessity were key barriers. Six qualitative themes were identified: economic strain, access gaps, cultural beliefs, religious coping, caregiving burden, and symptom management issues.ConclusionThis first study of medication adherence in Jordanian multimorbidity highlights actionable barriers and facilitators, offering a scalable model for resource-limited settings. Subsidies, mobile pharmacies, and culturally tailored strategies could substantially reduce the non-adherence rates, advancing NCD control regionally and globally. |
| format | Article |
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| institution | DOAJ |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-3acaae02a0854f7197f9fa8e5b248d372025-08-20T03:15:37ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.16190231619023Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinicsAnas Abed0Mohammad Abu Assab1Wael Abu Dayyih2Badriyah S. Alotaibi3Nawal Alsubaie4Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, JordanClinical Pharmacy Department, Faculty of Pharmacy, Zarqa University, Zarqa, JordanFaculty of Pharmacy, Mutah University, Alkarak, JordanDepartment of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi ArabiaDepartment of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi ArabiaBackgroundMultimorbidity, the coexistence of two or more chronic conditions, is increasingly prevalent in Jordan, a middle-income country with a growing non-communicable disease (NCD) burden and limited data on medication adherence. This study examined adherence prevalence, predictors, and barriers among Jordanians with multimorbidity to inform interventions supporting Sustainable Development Goal 3.MethodsA cross-sectional, mixed-methods study was conducted from April to December 2024 in two tertiary Hospitals’ outpatient clinics in Amman. Adults (≥18 years) with ≥2 chronic conditions requiring ongoing medication (n = 405) were recruited via convenience sampling. Adherence was assessed using the General Medication Adherence Scale (GMAS, 0–33; high adherence defined as GMAS ≥27) alongside a Self-Administered Comorbidity Questionnaire (SCQ)-like checklist. Qualitative data were collected through an open-ended question and analyzed using thematic analysis. Descriptive statistics, correlation analysis, and logistic regression were used. Qualitative data were analysed using thematic analysis.ResultsOf 420 invited participants, 405 completed the survey (response rate: 96.4%). High adherence (GMAS ≥27) was observed in 54.3% of participants. Factors positively associated with medication adherence included older age, higher income, fewer medications, higher health literacy, and social support, while cost, polypharmacy, forgetfulness, rural residence, and low perceived medication necessity were key barriers. Six qualitative themes were identified: economic strain, access gaps, cultural beliefs, religious coping, caregiving burden, and symptom management issues.ConclusionThis first study of medication adherence in Jordanian multimorbidity highlights actionable barriers and facilitators, offering a scalable model for resource-limited settings. Subsidies, mobile pharmacies, and culturally tailored strategies could substantially reduce the non-adherence rates, advancing NCD control regionally and globally.https://www.frontiersin.org/articles/10.3389/fphar.2025.1619023/fullmedication adherencemultimorbiditychronic disease multimorbiditypolypharmacymixed-methods approach |
| spellingShingle | Anas Abed Mohammad Abu Assab Wael Abu Dayyih Badriyah S. Alotaibi Nawal Alsubaie Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics Frontiers in Pharmacology medication adherence multimorbidity chronic disease multimorbidity polypharmacy mixed-methods approach |
| title | Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics |
| title_full | Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics |
| title_fullStr | Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics |
| title_full_unstemmed | Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics |
| title_short | Medication adherence in Jordanian patients with multimorbidity: a cross-sectional mixed-methods study in outpatient clinics |
| title_sort | medication adherence in jordanian patients with multimorbidity a cross sectional mixed methods study in outpatient clinics |
| topic | medication adherence multimorbidity chronic disease multimorbidity polypharmacy mixed-methods approach |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1619023/full |
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