Medication Adherence among Patients with Chronic Diseases in Saudi Arabia

A Cross-Sectional Survey on the Management of Medication Adherence Among Healthcare Professionals in Saudi Arabia

BACKGROUND/OBJECTIVES

Medication adherence is essential for effective healthcare, significantly influencing treatment success and overall health outcomes. However, there is limited understanding of how healthcare professionals in Saudi Arabia manage and support medication adherence. This study aims to examine physicians' and pharmacists' approaches to managing medication adherence in Saudi Arabia by examining the methods used for adherence assessment, interventions to enhance adherence, and the challenges faced.

METHODS

A cross-sectional study was conducted over nine months using a self-administered online questionnaire. The study targeted physicians and pharmacists actively working in Saudi Arabia. The questionnaire was distributed through professional networks to ensure a broad and representative sample.

RESULTS

A total of 397 healthcare professionals met the inclusion criteria, comprising 81.1% pharmacists and 18.9% physicians. Direct patient inquiry was the most common assessment method, frequently or always used by 81.3% of physicians and 57.1% of pharmacists. Treatment response evaluation was similarly frequent (89.3% of physicians and 56.2% of pharmacists). Standardized tools, such as the Morisky Medication Adherence Scale, were underutilized (14.7%). Adherence-enhancing interventions focused on patient education, and their use was reported by 89.3% of physicians and 74.2% of pharmacists as frequent or always. Written information was more commonly used by pharmacists (65.8%) than physicians (45.3%). Barriers included excessive workloads and short consultation times (59.9%), absence of effective systems for tracking adherence (51.9%), lack of reliable tools for assessing adherence (48.9%), and insufficient training in behavioral interventions (48.1%).

CONCLUSIONS

This study reveals significant differences in medication adherence management practices between physicians and pharmacists in Saudi Arabia, emphasizing their distinct roles. Key barriers, including excessive workload, limited consultation time, and inadequate tracking systems, hinder the adoption of evidence-based tools. Tailored interventions, enhanced interprofessional collaboration, and systemic support are essential to address these challenges and improve adherence management, ultimately enhancing patient outcomes.

Suitability of Measures of Pharmacy-Based Medication Adherence for Routine Clinical Use Among Patients with Chronic Diseases: A Systematic Review

Purpose

To identify the suitability of pharmacy-based measures for determining medication adherence in routine clinical use.

Methods

Data were obtained through PubMed and Scopus databases up to December 2023 without publication year restrictions. This review included English studies on assessing medication adherence for hypertension, hyperlipidemia, asthma, chronic obstructive pulmonary disease, and diabetes, using pharmacy databases and providing full-text access. We investigated evidence quality utilizing the Newcastle-Ottawa Scale for non-randomized studies (cohort, case-control, and cross-sectional) and the Risk of Bias Assessment Tool for Non-randomized Studies-2 and JADAD scales for quasi-experiments and randomized control trials, respectively. We determined validity characteristics (completeness, accuracy, reliability, objectivity, continuous adherence history, non-intrusiveness, sensitivity, and specificity) and applicability (cost-effectiveness, ease of use, and interpretability) to evaluate the suitability of pharmacy-based medication adherence measures in clinical settings.

Results

This review retrieved 1513 studies, of which 74 met the inclusion criteria. All of the studies, which were published from 2000 to 2023 and mostly utilized a retrospective cohort design (n = 53), included 17.6 million patients. Of the 74 studies, 50 were conducted in the United States. Diabetes mellitus (n = 40) was the most prevalent disease, whereas the medication possession ratio (n = 46) and prescription days covered (n = 31) were the most prevalent pharmacy-based matrix. According to the results, 73 articles demonstrated validity characteristics, whereas 1 article lacked these characteristics. All 74 (100%) articles had applicability characteristics.

Conclusion

This systematic review demonstrates that pharmacy-based measures possess valid characteristics, including comprehensive, accurate, objective, reliable, and continuously updated adherence history records. These measures are designed to minimize disruption while offering high sensitivity and specificity. Furthermore, they are characterized by their practicality, being cost-effective, easy to implement, and easy to interpret. These findings suggest that pharmacy-based measures are potentially suitable to assess medication adherence for routine clinical use.

Status of diabetes mellitus in different regions of KSA and update on its management

Background

Complications of diabetes and its associated comorbidities can cause rapid progression of type II diabetes mellitus (T2DM). It comes at high costs and affects a patient's quality of life. We aim to assess T2DM in KSA, including the demographics, medications, complications, and comorbidities, as it remains an integral part of Vision 2030.

Methods

Observational retrospective study was designed spanning five administrative regions of KSA. A total of 638 patients' records were randomly selected from general hospitals and diabetes centers from 2017 to 2020, and the collected were statistically analyzed.

Results

Most (77%) selected patients had uncontrolled diabetes, showing a statistically significant correlation between regions and diabetes control. The Northern, Central, and Southern regions had the highest uncontrolled percentage with less than 20% control, while Western and Eastern regions' control percentages were around 40% of subjects. Eighty percent of the uncontrolled BP patients had uncontrolled diabetes contrasting the 68% of the BP-controlled patients. Biguanides, DPP-4 inhibitors, GLP-1 agonists, Insulin, and SGLT-2 inhibitors are the most common diabetes medications. Metformin was the most prescribed in all regions, followed by DPP4. Results showed that patients used one to four non-diabetes drugs on average. Dispensing of vitamin B complex and statins were higher in diabetes centers than in hospitals. Retinopathy and peripheral neuropathy were the most common complications, while hypertension and ASCVD were the most common comorbidities.

Conclusion

Results showed a poor glycemic control situation in the kingdom that necessitates implementing stricter measures to hinder disease progression and reduce complications and comorbidities. Increasing awareness, training, and monitoring programs with larger sample sizes and broader distribution is highly recommended nationally.

Predictors to Poor Quality of Life Among Patients with Heart Failure and Its Correlation with Their Medication Adherence: Finding for Healthcare Improvement and Follow-Up

Background

Understanding medication adherence and its relationship with quality of life (QoL) is essential for improving health outcomes in patients with heart failure (HF).

Objective

This study aimed to investigate the predictors of poor quality of life and its relationship with medication adherence among patients with heart failure.

Methods

A cross-sectional correlational study was performed on 229 patients with HF receiving care at the Cardiac Center of King Salman Specialist Hospital from March to June 2024. Data were collected using a structured questionnaire comprising patient demographics, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to assess QoL, and the General Medication Adherence Scale (GMAS) to measure medication adherence.

Results

The mean medication adherence score among patients with heart HF was 17.53 ± 6.94. The level of adherence was moderate among most patients (47.2%), high (29.7%), and poor (23.1%). Regarding QoL, the mean total score for overall QoL was 42.16 ± 20.53. Specifically, the mean scores were 15.24 ± 8.65 and 10.53 ± 5.82 for the physical and emotional dimensions of QoL, respectively. More than half of the patients experienced poor QoL, while moderate QoL was observed in 31.9% and good QoL in 17% of patients. Furthermore, there were moderate negative correlations between medication adherence and physical QoL (r= -0.51), emotional QoL (r = -0.59), and overall QoL (r = -0.59), all of which were statistically significant (p <0.001).

Conclusion

Moderate-to-poor levels of medication adherence and QoL were found among HF patients receiving care in Hail City. Therefore, interventions to improve medication adherence among patients with HF must be prioritized to enhance health outcomes and QoL. It is also crucial to address the factors that negatively influence medication adherence to overcome the barriers that hinder optimal medication adherence.

Evaluating Strategies for Enhancing Medication Adherence in the Kingdom of Saudi Arabia (KSA): A Cross-Sectional Study

Purpose

This study aimed to assess medication adherence strategies among users in Saudi Arabia, explore the prevalence and effectiveness of behavioral, technical, and organizational tools, and identify key predictors of adherence related to demographic, health, and medication characteristics.

Patients and Methods

A descriptive cross-sectional study was conducted among 250 Saudi residents aged ≥18 who regularly take prescription/non-prescription medications. The questionnaire was developed through a literature review, validated by academic pharmacists, and refined based on pilot testing feedback. A convenience sampling method, complemented by snowball sampling, was employed to recruit participants. Limitations like sampling bias and self-reported data emphasize the need for broader studies. Quantitative analysis was performed using IBM SPSS.

Results

Participants were predominantly young adults (84%) and females (84%), with 54% reporting being healthy and 46% managing chronic conditions. Behavioral strategies, such as time-based reminders, were the most commonly used (40%), followed by technical tools (33%), including mobile applications. Employment status significantly influenced adherence, with employed individuals (adjusted OR: 3.274, p = 0.028) and those working >8 hours daily (adjusted OR: 9.838, p = 0.049) exhibiting higher adherence. Fieldwork negatively impacted adherence (adjusted OR: 0.052, p = 0.007). While other demographic and health factors showed no significant associations, trends suggested that complex medication regimens increased the likelihood of using adherence strategies.

Conclusion

Behavioral strategies, such as time- and location-based reminders, and technical tools, like apps, effectively improved medication adherence. Healthcare providers should promote simple, cost-effective methods, such as pillboxes and mobile reminders, tailored to patient needs. Addressing adherence barriers for individuals with demanding/unexpected schedules or complex regimens through targeted interventions and awareness campaigns is essential. Future research should explore these strategies' scalability and long-term impact in diverse healthcare settings.

Development and validation of the Out-of-Hospital Adherence Questionnaire for Stroke Patients (OHAQ-SP)

BACKGROUND

The extent of rehabilitation of stroke patients outside the hospital is contingent upon their dedication to rehabilitative exercises, adherence to a suitable diet, and medication protocols. Therefore, multiple aspects of compliance must be assessed. Questionnaires are indirect measurements that are economical and easy to use. However, questionnaires should meet specific criteria to minimize errors and ensure reprehensibility of the results.

OBJECTIVE

To develop a new questionnaire-based assessment tool for out-of-hospital treatment adherence in stroke patients and to evaluate the psychometric properties and feasibility of the questionnaire by conducting preliminary measurements in the stroke population. The questionnaire should have at least one validity measure and one reliability measure.

METHODS

A preliminary "OHAQ-SP" was developed based on a literature review and two rounds of Delphi expert consultation. Between April 1 and July 2022, 308 stroke patients revisited the neurology departments of four Grade A tertiary hospitals in Shanghai using the convenience sampling approach. Various statistical methods, such as item analysis, correlation analysis, exploratory factor analysis, confirmatory factor analysis, and the internal consistency measure Cronbach's α coefficient, were employed to assess the reliability and validity of the questionnaire.

RESULTS

A total of 290 questionnaires were collected; the Cronbach's α coefficients were 0.936, 0.862, 0.916, and 0.928 for the different sections, and the overall Cronbach's α coefficient for the entire scale was 0.902. The results of the confirmatory factor analysis were CMIN/DF = 2.490, RMR = 0.05, GFI = 0.901, NFI = 0.927, IFI = 0.955, and RMSEA = 0.054. The standardized loading values varied between 0.717 and 0.916. The combined reliabilities of the four dimensions were 0.936, 0.864, 0.917, and 0.929, respectively. The average variance extraction values for the four dimensions are 0.676, 0.614, 0.611, and 0.652, respectively.

CONCLUSION

The OHAQ-SP is a reliable and accurate instrument for evaluating medication use, nutritional status, and behavior throughout the out-of-hospital rehabilitation phase.

Evaluation of Hypertension-Related Knowledge, Medication Adherence, and Associated Factors Among Hypertensive Patients in the Aljouf Region, Saudi Arabia: A Cross-Sectional Study

Background and Objectives: Hypertensive patients' knowledge and adherence to prescribed medicines are critical in managing their condition, as poor adherence may lead to adverse cardiac and cerebrovascular events. The present study assessed hypertension-related knowledge and medication adherence among hypertensive patients attending primary health centers (PHCs) in the Aljouf Province, Saudi Arabia. Materials and Methods: Using a cross-sectional design, we conducted this survey on 390 patients. Self-reported hypertension knowledge was assessed using the Hypertension Knowledge Level Scale (HK-LS), and medication adherence was determined using the Hill-Bone Medication Adherence Scale. We used binomial regression analysis (adjusted with other variables) to find the associated factors of medication adherence. Results: This study found that nearly half (49.2%) of the participants had inadequate knowledge, and poor medication adherence was noted in 40.8% of the participants. We found a positive correlation between HK-LS and the Hill-Bone Medication Adherence Scale scores (Spearman's rho = 0.312, p = 0.002). Medication adherence was significantly associated with job status (private sector (ref: public sector, adjusted odds ratio [AOR] = 2.02, 95% CI = 1.18-3.62, p = 0.005)), living in an urban region (ref: rural, AOR = 3.61, 95% CI = 1.85-5.72, p = 0.002), and duration since diagnosis of more than 5 years (ref: ≤1 year, AOR = 3.53, 95% CI = 2.36-4.95, p = 0.001). Conclusions: The present study findings indicate that there is still a critical gap in managing hypertension at the PHCs in this region, and this may lead to poor health outcomes among the patients and burden the healthcare system. Hence, continuous patient education and targeted counseling are recommended for those with poor medication adherence.

Treatment Adherence and Health-Related Quality of Life Among Patients with Hypertension at Tertiary Healthcare Facility in Lalitpur, Nepal: A Cross-Sectional Study

Background

Measurement of medication adherence and health-related quality of life is extremely important when planning different health policies. Drug therapy and adherence to medication are critical to prevent complications of hypertension, especially in countries like Nepal, where hypertension is one of the most prevalent diseases. However, this has not been studied in Nepal. This study, hence, aimed to explore medication adherence, factors affecting medication adherence, health-related quality of life, and the correlation between medication adherence and health-related quality of life in hypertensive patients visiting tertiary care health facilities in Lalitpur district of Nepal.

Methodology

This quantitative cross-sectional study was conducted among 380 hypertensive patients at KIST Medical College and Teaching Hospital, Lalitpur, Nepal. The Nepali version of the European Quality of Life tool EQ-5D-5L and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) were used. Intergroup differences in medication adherence, the EQ-5D index and EQ-VAS scores were assessed for statistical significance using either the Mann-Whitney or Kruskal-Wallis tests for numerical data. Spearman correlation coefficient was used to identify the relationship among medication adherence, EQ-5D-5L index values, and EQ-VAS scores.

Results

The mean treatment score was 22.43 ± 4.12. Age, sex, and occupation were significant factors that affected treatment adherence. The EQ-5D score was 0.72 with age, sex, income, and educational status as significant factors and marital status as an insignificant factor. A slightly negative correlation was found between the total treatment adherence score and the EQ-5D index.

Conclusion

The treatment adherence of patients to antihypertensive therapy was suboptimal, which could affect the outcome of therapy. Better treatment adherence was correlated with a better health-related quality of life. Hence, both health-care providers and patients should make efforts to increase treatment adherence to attain better HRQOL.

Potential Applications of Artificial Intelligence (AI) in Managing Polypharmacy in Saudi Arabia: A Narrative Review

Prescribing medications is a fundamental practice in the management of illnesses that necessitates in-depth knowledge of clinical pharmacology. Polypharmacy, or the concurrent use of multiple medications by individuals with complex health conditions, poses significant challenges, including an increased risk of drug interactions and adverse reactions. The Saudi Vision 2030 prioritises enhancing healthcare quality and safety, including addressing polypharmacy. Artificial intelligence (AI) offers promising tools to optimise medication plans, predict adverse drug reactions and ensure drug safety. This review explores AI's potential to revolutionise polypharmacy management in Saudi Arabia, highlighting practical applications, challenges and the path forward for the integration of AI solutions into healthcare practices.

Barriers to Medication Adherence Among Patients with Non-Communicable Disease in North Wollo Zone Public Hospitals: Socio-Ecologic Perspective, 2023

Background

The practice of taking medication as directed by a healthcare provider is known as medication adherence. Therefore, the application of a socio-ecological model to this study identifies multilevel factors on barriers of medication adherence on chronic non-communicable disease and provides information to develop scientific health communication interventional strategies to improve medication adherence.

Objective

This study aimed to explore barriers of medication adherence on non-communicable disease prevention and care among patients in North Wollo Zone public hospitals, northeast Ethiopia.

Methods

A phenomenological study design was carried out between February 5 and February 30, 2023. The study participants were chosen using a heterogeneous purposive sampling technique. In-depth interviews and targeted focus groups were used to gather data. The focus group discussions and in-depth interviews were captured on audio, accurately transcribed, and translated into English. Atlas TI-7 was utilized to do the thematic analysis.

Results

Four main themes, intrapersonal, interpersonal, community level, and health care related, as well as seven subthemes, financial problems, lack of family support, poor communication with healthcare providers, effects of social ceremonies, remote healthcare facility, and drug scarcity, were identified by this study. In this study participants reported that lack of knowledge about the disease and drugs were the main barrier for medication adherence. The study revealed that financial problems for medication and transportation cost were the main factor for medication adherence for non-communicable disease patients.

Conclusion

This study explored that lack of knowledge, financial problem, lack of family support, poor communication with healthcare providers, social ceremony effects, remote healthcare facility, and scarcity of drugs were barriers of medication adherence among non-communicable disease patients. In order to reduce morbidity and mortality from non-communicable diseases, it is advised that all relevant bodies look for ways to reduce medication adherence barriers for patients at every level of influence.

Validity, sensitivity and specificity of a measure of medication adherence instrument among patients taking oral anticoagulants

Although self-report instruments are currently considered a valuable tool for measuring adherence, due to their low cost and ease of implementation, there are still important factors that impact measurement accuracy, such as social desirability and memory bias. Thus, the Global Assessment of Medication Adherence Instrument (GEMA) was developed to provide an accurate measure of this construct. The aim of this study was to evaluate the properties of the measurement of the Global Evaluation of Medication Adherence Instrument (GEMA) among patients with chronic diseases. A methodological study was conducted in the public hospital of the state of São Paulo, Brazil. The adherence to anticoagulants as well as the international normalized ratio (INR) was assessed on 127 patients. Besides GEMA, two other instruments were used to assess adherence: the Morisky Medication Adherence Scale-8 (MMAS-8) and the Measurement of Adhesion to Treatments (MAT). The GEMA presented a satisfactory level of specificity (0.76) to identify adherents among those with a stable INR, low sensitivity (0.43) for the identification of non-adherents among those with an unstable INR, and a Positive Predictive Value of 0.70. Positive and weak to moderate correlations were observed between the proportion of doses assessed with GEMA and the scores on the MMAS-8 (r = .26 and r = .22, respectively) and the MAT (r = .22 and r = .30, respectively). The GEMA presented good practicality, acceptability, and evidence of specificity regarding the stability of the INR. The validity of the construct was partially supported by the relationship with self-reported measures of adherence.

Prevalence of Nonadherence to Medications among Geriatric Patients in Al-Madinah Al-Munawara City's Hospitals, Kingdom of Saudi Arabia

Introduction

Medication adherence is a major component in the treatment of chronic patients, especially the older adults. It acts as an essential part of a successful therapeutic outcome, increasing treatment benefits, and decreasing hospital admissions, health care utilization, and cost. Limited research regarding medication adherence has been conducted nationwide; however, data among the older adults is sparse due to the lack of research on this topic. Therefore, this study aimed to determine the prevalence of medication nonadherence among older adults' Saudi patients with chronic diseases living in Al-Madinah Al-Munawwarah city.

Method

A cross-sectional study was conducted on outpatient older patients with chronic diseases who visited clinics at different hospitals in Al-Madinah Al-Munawwarah city, from March until December 2022. The questionnaire was published in a conversational Arabic dialect. The adherence level was measured by the Adherence to Refills and Medications Scale (ARMS) and the reasons for medication nonadherence were collected by using the Cluig scale.

Results

65.1% of females and 34.9% of males have participated in this study. According to the ARMS scale, 67.9% of patients had poor medication adherence and 32.1% had good medication adherence. Poor adherence was higher in females compared to males, with a p value = 0.018. For educational level, the ARMS score in graduates was higher than patients who finished middle school and illiterate patients. Based on the Cluig scale, the most common reasons for medication nonadherence were forgetfulness, feeling well, polypharmacy, and subsequent avoidance of side effects. The findings indicate the gender-based differences in the factors that associated with medication nonadherence among older adults.

Conclusion

Medication adherence is crucial especially among older adults to improve clinical outcomes. The current results highlight the prevalence of medication adherence among the older adult population. This result shows the gender-based differences in the factors associated with medication nonadherence among the older adult population.

Continuity of care in primary healthcare settings among patients with chronic diseases in Saudi Arabia

Introduction

Maintaining continuity of care is one of the most critical components of providing great care in primary health care. This study aimed to explore continuity of care and its predictors in primary healthcare settings among patients with chronic diseases in Saudi Arabia.

Method

Face-to-face cross-sectional interviews were conducted with patients with chronic diseases who had at least four visits to primary care facilities in Riyadh, Saudi Arabia, between November 1, 2022 and March 3, 2023. We determined patients' continuity of care levels using the Bice-Boxerman continuity of care index. A Tobit regression model was used to determine the effects of several factors on the continuity of care index.

Results

The interviews were conducted with 193 respondents with chronic diseases of interest. The mean continuity of care index of the entire sample was 0.54. Those with asthma had the highest median continuity of care index at 0.75 (interquartile range, 0.62-0.75), whereas those diagnosed with thyroid disease had a much lower continuity of care index (0.47) (interquartile range, 0.3-0.62). Tobit regression model findings showed that employed respondents with poorer general health had a negative effect on continuity of care index levels. By contrast, a higher continuity of care index was significantly associated with elderly respondents, urban residents, and those diagnosed with dyslipidemia, diabetes, hypertension, or asthma.

Conclusions

According to our findings, the continuity of care level in Saudi Arabia's primary healthcare setting is low. The data demonstrate how continuity of care varies among study group characteristics and that improving continuity of care among chronic disease patients in Saudi Arabia is multifaceted and challenging, necessitating a coordinated and integrated healthcare delivery approach.

Highlighting the Use of the Hepatoprotective Nutritional Supplements among Patients with Chronic Diseases

Cross-sectional studies, while not considered glamorous endeavors, are firmly anchored in data and statistics, providing essential insights about public health. The aim of the study is to see the frequency of hepatoprotective (HP) nutritional supplement consumption among patients with chronic diseases (other than chronic liver disorders) and analyzes the habits related to the consumption of nutritional supplements among these patients. A total of 954 patients, seeking medical prescriptions for chronic diseases under various payment arrangements (compensated, gratuity, or full payment) were carefully selected over a 12-month period from four private pharmaceutical facilities. We examined the frequency of HP consumption in relation with a number of prescribed medications for chronic conditions. All these patients were invited to complete a questionnaire about their supplement consumption habits and were provided the option to participate in a nutritional status assessment. One hundred ninety-five patients consented to participate in the survey, and 65 patients agreed to undergo a nutritional status evaluation. Of the 954 patients, 77.2% incorporate HP into their regimen. The most frequent consumption (83.33%) was recorded in a group with seven drugs, followed by a group with three drugs (82.84%). Women have a higher usage rate of HP (80.58%; 444 from 551) compared to men (62.60%; 293 from 383), and most of the patients (59.5%) used extracts of Silybum marianum L. In the survey, 64.61% of participants were using supplements, with most (59.52%) consuming HP. Only 32.54% of patients rely on recommendations from healthcare professionals. Of the patients who use supplements, 55.56% reported improvements in their health status. Furthermore, patients who integrate supplements into their daily routine tend to achieve better overall nutritional status.

Relationship between Treatment Burden, Health Literacy, and Medication Adherence in Older Adults Coping with Multiple Chronic Conditions

A prospective study was conducted to investigate the impact of treatment burden and health literacy on medication adherence among older adults with multiple chronic conditions (MCC) and to explore the potential moderating effects of demographic and clinical factors. Face-to-face structured interviews were conducted among older adults aged 60 and above using the Burden of Treatment Questionnaire (TBQ-15), Short Form Health Literacy Questionnaire (HLS-SF12), and Malaysia Medication Adherence Assessment Tool (MyMAAT). This study included 346 older adults aged 60 years and above with two or more chronic conditions (n = 346). Hypertension (30.2%), hyperlipidemia (24.0%), and diabetes (18.0%) were the most reported chronic conditions among participants. The mean score of treatment burden was 53.4 (SD = 28.2), indicating an acceptable burden of treatment. The mean score of health literacy was 16.4 (SD = 12.6), indicating a limited health literacy level among participants; meanwhile, the mean score of medication adherence was 32.6 (SD = 12.3), indicating medication non-adherence among participants. Medication adherence was significantly correlated with treatment burden (r = -0.22, p < 0.0001), health literacy (r = 0.36, p < 0.0001), number of chronic conditions (r = -0.23, p < 0.0001), and age (r = -0.11, p < 0.05). The study findings emphasize that multimorbid older adults with high treatment burdens and low health literacy are more likely to have poor medication adherence. This underscores the importance for clinicians to address these factors in order to improve medication adherence among older adults with multiple chronic conditions (MCC).

Molecular Role of Asn680Ser and Asp37Glu Missense Variants in Saudi Women with Female Infertility and Polycystic Ovarian Syndrome

Female infertility (FI) is a global health issue. Polycystic ovary syndrome (PCOS) is a common cause of FI. The renalase gene (RNLS) is associated with FI and other human diseases. Based on the documented missense variants, rs6166 and rs2296545 single-nucleotide polymorphisms (SNPs) were not identified in Saudi women with FI and PCOS. This study aimed to investigate the molecular role of the two SNPs in Saudi women with FI and PCOS. In this cross-sectional study, 96 healthy controls, 96 women with FI, and 96 women with PCOS were recruited. DNA was isolated, and polymerase chain reactions and Sanger sequencing analysis were performed using rs6166 and rs2296545 SNPs. The data obtained from the three groups were used to perform statistical analyses based on genotype, allele frequencies, regression models, and ANOVA analysis. Both rs6166 and rs2296545 had no role in FI or PCOS in Saudi women. A predicted reason for non-association in Saudi women could be the role of elderly women in the controls compared with women with FI and PCOS. Moreover, age, weight, and body mass index were higher in the control group than the FI and PCOS groups. In conclusion, rs6166 and rs2296545 SNPs were not associated with FI or PCOS in Saudi women.

Insights Into Medication Adherence Among Patients With Chronic Diseases in Jeddah, Saudi Arabia: A Cross-Sectional Study

Background Non-adherence to medication is a common problem in managing chronic diseases, which are a significant public health concern globally. This study aimed to identify factors related to medication adherence among patients with chronic diseases in Saudi Arabia. Methods A cross-sectional survey design was used to collect data through an online survey administered to 400 patients with chronic diseases residing in Jeddah between January and March 2023. The survey included questions about socio-demographic characteristics, chronic disease diagnosis, medication adherence, and factors that may influence medication adherence. Results This study recruited 400 participants and found that the majority were female, with a mean age of 46.2 years, and most had at least one chronic disease, with hypertension and diabetes being the most common. The medication adherence score for the entire sample was 5.4, indicating moderate adherence. Overall, 22.9% of study participants had poor adherence to medications. Factors associated with medication adherence included age, gender, and education level, with older age, female gender, and higher education being positively associated with adherence. Medication-related factors such as the number of medications prescribed, medication complexity, and medication cost were also found to be significantly associated with medication adherence. Conclusion Our study of medication adherence among chronic disease patients in Saudi Arabia found that adherence rates were moderate, with several factors significantly associated with better adherence. Specifically, older age, female gender, and higher education level were positively associated with better adherence, while a higher number of prescribed medications, more complex medication regimens, and higher medication costs were all significant predictors of poorer adherence.

Lifestyle Assessment of Primary Healthcare Physicians in Taif, Saudi Arabia in the Year 2022

Objective This study aims to evaluate primary healthcare physicians' lifestyles to promote their well-being and improve care quality for the general population. Methods This cross-sectional quantitative study was conducted on primary healthcare physicians in Taif, Kingdom of Saudi Arabia (KSA), using self-administered questionnaires. Results We included 206 participants aged 26-66. Most participants were 35 years old or younger (67%), male (62.1%), and residents (52.4%). Of all participants, 49.5% held a Bachelor's degree, 40.8% had completed their board certificate or Ph.D., and 69.9% had at least 10 years of experience. Of all participants, 16.5% and less than 9% reported having hypercholesterolemia and other comorbidities, respectively. More than 50% were physically inactive, 26.2% were moderately inactive, and 17.4% were moderately active or active individuals. Physical activity was significantly associated with job titles (p < 0.018). The qualification was associated with dietary score (p = 0.034), and 42.7% of participants were in need of diet change. About a quarter (25.2%) were smokers, and 92.3% of them smoked daily. Male participants were associated with a greater likelihood of smoking (p < 0.001). Overall, 41.7% were overweight, and 25.7% were obese. Increased BMI was associated with older age and male gender (p < 0.001 and p < 0.002, respectively), as well as the title of the physician and years of experience (p < 0.001 and p < 0.002, respectively). Conclusion Participants' unhealthy lifestyles indicate the need to establish measures to promote healthy lifestyles among physicians.