Medication Adherence Among Adults with Diabetes in Jazan, Saudi Arabia: Role of Pharmacist Support and Digital Health.
Medication adherence is critical for achieving optimal glycemic control and preventing diabetes-related complications. However, poor adherence remains a major barrier to effective diabetes management worldwide. Evidence regarding factors associated with medication adherence among adults with diabetes in Saudi Arabia remains limited. This study aimed to assess medication adherence among adults with diabetes and examine associations of sociodemographic, clinical, pharmacist-related, and digital health factors with adherence levels.
A cross-sectional study was conducted among adults with type 1 or type 2 diabetes attending a specialized diabetes center in Jazan, Saudi Arabia, during February-March 2025. Participants were recruited using non-probability convenience sampling. Of 489 patients approached, 388 completed the questionnaire, yielding a response rate of 79.3%. Data were collected using a bilingual (Arabic/English) electronic questionnaire. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, bivariate analyses, correlation analysis, and multinomial logistic regression were performed using IBM SPSS Statistics version 27.
Overall, 77.1% of participants demonstrated low medication adherence, while 16.5% and 6.4% demonstrated moderate and high adherence, respectively. In the adjusted multinomial logistic regression model, higher satisfaction with the current diabetes management plan was significantly associated with greater odds of moderate adherence (OR=1.650, 95% CI: 1.212-2.245, P=0.001) and high adherence (OR=2.038, 95% CI: 1.165-3.565, P=0.013) compared with low adherence. Insulin use was associated with moderate vs low adherence (OR=2.175, 95% CI: 1.008-4.692, P=0.048), but not with high adherence. Participants who did not use mobile applications or digital health tools had higher odds of high vs low adherence than those who used such tools (OR=2.685, 95% CI: 1.007-7.154, P=0.048). Age and comorbid conditions were not significantly associated with adherence level in the adjusted model. Frequency of pharmacist consultation was significant overall (P=0.001), although individual category comparisons did not demonstrate a consistent pattern across adherence levels. Multicollinearity diagnostics indicated no problematic collinearity (VIF=1.04-1.34; tolerance ≥0.75).
Medication adherence was predominantly low among study participants. Higher satisfaction with diabetes management was consistently associated with greater adherence, while insulin use and digital health tool use showed category-specific associations. The unexpected association between digital-tool non-use and high adherence should be interpreted cautiously and does not establish a causal effect of digital technology on adherence. Further longitudinal and prospective studies are warranted to clarify these associations and determine how structured pharmacist engagement and personalized digital-health strategies can be optimally incorporated into patient-centered diabetes care.
A cross-sectional study was conducted among adults with type 1 or type 2 diabetes attending a specialized diabetes center in Jazan, Saudi Arabia, during February-March 2025. Participants were recruited using non-probability convenience sampling. Of 489 patients approached, 388 completed the questionnaire, yielding a response rate of 79.3%. Data were collected using a bilingual (Arabic/English) electronic questionnaire. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, bivariate analyses, correlation analysis, and multinomial logistic regression were performed using IBM SPSS Statistics version 27.
Overall, 77.1% of participants demonstrated low medication adherence, while 16.5% and 6.4% demonstrated moderate and high adherence, respectively. In the adjusted multinomial logistic regression model, higher satisfaction with the current diabetes management plan was significantly associated with greater odds of moderate adherence (OR=1.650, 95% CI: 1.212-2.245, P=0.001) and high adherence (OR=2.038, 95% CI: 1.165-3.565, P=0.013) compared with low adherence. Insulin use was associated with moderate vs low adherence (OR=2.175, 95% CI: 1.008-4.692, P=0.048), but not with high adherence. Participants who did not use mobile applications or digital health tools had higher odds of high vs low adherence than those who used such tools (OR=2.685, 95% CI: 1.007-7.154, P=0.048). Age and comorbid conditions were not significantly associated with adherence level in the adjusted model. Frequency of pharmacist consultation was significant overall (P=0.001), although individual category comparisons did not demonstrate a consistent pattern across adherence levels. Multicollinearity diagnostics indicated no problematic collinearity (VIF=1.04-1.34; tolerance ≥0.75).
Medication adherence was predominantly low among study participants. Higher satisfaction with diabetes management was consistently associated with greater adherence, while insulin use and digital health tool use showed category-specific associations. The unexpected association between digital-tool non-use and high adherence should be interpreted cautiously and does not establish a causal effect of digital technology on adherence. Further longitudinal and prospective studies are warranted to clarify these associations and determine how structured pharmacist engagement and personalized digital-health strategies can be optimally incorporated into patient-centered diabetes care.
Authors
Sahli Sahli, Almuqbil Almuqbil, Alrouwaijeh Alrouwaijeh, Alhazmi Alhazmi, Alraythi Alraythi, Alattas Alattas, Meshari Meshari, Kharizi Kharizi, Mobaraki Mobaraki, Alshlali Alshlali, Moafa Moafa, Shwia Shwia, Gilkaramenthi Gilkaramenthi, Asdaq Asdaq
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