Medication Adherence and Healthcare Management Strategies Among patients with chronic Diseases
DOI:
https://doi.org/10.70749/ijbr.v4i5.3234Keywords:
Medication adherence, chronic diseases, healthcare management, patient education, Pakistan, treatment complexity, healthcare support, self-managementAbstract
This study aimed to assess medication adherence and healthcare management strategies among patients with chronic diseases in Punjab, Pakistan. A quantitative cross-sectional research design was used, and data were collected from 200 patients selected through a convenience sampling technique from selected healthcare facilities. A structured questionnaire was used to gather information on medication adherence levels, influencing factors, and healthcare management strategies. Data were analyzed using SPSS version 26, employing descriptive statistics, Pearson correlation, and post hoc analysis. The results revealed that a majority of patients exhibited moderate medication adherence, while a significant proportion showed low adherence. Correlation analysis indicated a significant positive relationship between medication adherence and patient knowledge as well as healthcare support, whereas treatment complexity showed a negative association with adherence. Post hoc analysis further confirmed significant differences in adherence based on levels of knowledge, healthcare support, and treatment complexity. Additionally, factors such as financial constraints, medication side effects, and complex regimens were identified as major barriers to adherence, while patient education, follow-up care, reminder systems, and multidisciplinary healthcare approaches were found to improve adherence. The study concludes that medication adherence among chronic disease patients is influenced by multiple patient-related, treatment-related, and healthcare system factors. Strengthening patient education, improving healthcare delivery, and reducing financial barriers are essential to enhance adherence and improve health outcomes.
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References
1. Albishi, B. S., Baraja, M. A., Amashah, A. E., Alzahrani, B. M., & Alshaeri, A. M. (2024). Strategies for managing medication compliance in complex chronic conditions. J Healthc Sci, 4, 1057-1063.
https://doi.org/10.52533/johs.2024.41256
2. Al-Noumani, H., Al-Harrasi, M., Jose, J., Al-Naamani, Z., & Panchatcharam, S. M. (2022). Medication adherence and patients’ characteristics in chronic diseases: a national multi-center study. Clinical Nursing Research, 31(3), 426-434.
https://doi.org/10.1177/10547738211033754
3. Alosaimi, K., Alwafi, H., Alhindi, Y., Falemban, A., Alshanberi, A., Ayoub, N., & Alsanosi, S. (2022). Medication adherence among patients with chronic diseases in Saudi Arabia. International journal of environmental research and public health, 19(16), 10053.
https://doi.org/10.3390/ijerph191610053
4. Bąk-Sosnowska, M., Gruszczyńska, M., Wyszomirska, J., & Daniel-Sielańczyk, A. (2022, February). The influence of selected psychological factors on medication adherence in patients with chronic diseases. In Healthcare (Vol. 10, No. 3, p. 426). MDPI.
https://doi.org/10.3390/healthcare10030426
5. Balkrishnan, R. (2005). The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Medical care, 43(6), 517-520.
https://doi.org/10.1097/01.mlr.0000166617.68751.5f
6. Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024, November). Nurse-led interventions for improving medication adherence in chronic diseases: A systematic review. In Healthcare (Vol. 12, No. 23, p. 2337). MDPI.
https://doi.org/10.3390/healthcare12232337
7. Bhattarai, B., Walpola, R., Mey, A., Anoopkumar-Dukie, S., & Khan, S. (2020). Barriers and strategies for improving medication adherence among people living with COPD: a systematic review. Respiratory care, 65(11), 1738-1750.
https://doi.org/10.4187/respcare.07355
8. Brown, M. T., & Bussell, J. K. (2011, April). Medication adherence: WHO cares? In Mayo clinic proceedings (Vol. 86, No. 4, pp. 304-314). Elsevier.
https://doi.org/10.4065/mcp.2010.0575
9. Brummel, A., & Carlson, A. M. (2016). Comprehensive medication management and medication adherence for chronic conditions. Journal of managed care & specialty pharmacy, 22(1), 56-62.
https://doi.org/10.18553/jmcp.2016.22.1.56
10. Burnier, M. (2024). The role of adherence in patients with chronic diseases. European journal of internal medicine, 119, 1-5.
https://doi.org/10.1016/j.ejim.2023.07.008
11. Case, M. A., & Eakin, M. N. (2023). Up-to-date guidance towards improving medication adherence in patients with chronic obstructive pulmonary disease. Expert review of respiratory medicine, 17(7), 539-546.
https://doi.org/10.1080/17476348.2023.2239708
12. Chauke, G. D., Nakwafila, O., Chibi, B., Sartorius, B., & Mashamba-Thompson, T. (2022). Factors influencing poor medication adherence amongst patients with chronic disease in low-and-middle-income countries: A systematic scoping review. Heliyon, 8(6).
13. Chen, Y., Gao, J., & Lu, M. (2024). Medication adherence trajectory of patients with chronic diseases and its influencing factors: A systematic review. Journal of Advanced Nursing, 80(1), 11-41.
https://doi.org/10.1111/jan.15776
14. Cohen, J., Christensen, K., & Feldman, L. (2012). Disease management and medication compliance. Population health management, 15(1), 20-28.
15. Dong, J., Chu, M., & Xu, Y. (2025). A predictive healthcare model using machine learning and psychological factors for medication adherence. Healthcare Analytics, 7, 100397.
https://doi.org/10.1016/j.health.2025.100397
16. Elliott, R. A., Ross-Degnan, D., Adams, A. S., Safran, D. G., & Soumerai, S. B. (2007). Strategies for coping in a complex world: adherence behavior among older adults with chronic illness. Journal of general internal medicine, 22(6), 805-810.
17. Elnaem, M. H., Irwan, N. A., Abubakar, U., Syed Sulaiman, S. A., Elrggal, M. E., & Cheema, E. (2020). Impact of medication regimen simplification on medication adherence and clinical outcomes in patients with long-term medical conditions. Patient preference and adherence, 2135-2145.
https://doi.org/10.2147/ppa.s268499
18. Fallatah, M. S., Alghamdi, G. S., Alzahrani, A. A., Sadagah, M. M., & Alkharji, T. M. (2023). Insights into medication adherence among patients with chronic diseases in Jeddah, Saudi Arabia: a cross-sectional study. Cureus, 15(4).
19. Fernandez-Lazaro, C. I., García-González, J. M., Adams, D. P., Fernandez-Lazaro, D., Mielgo-Ayuso, J., Caballero-Garcia, A., ... & Miron-Canelo, J. A. (2019). Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC family practice, 20(1), 132.
https://doi.org/10.1186/s12875-019-1019-3
20. Gackowski, M., Jasińska-Stroschein, M., Osmałek, T., & Waszyk-Nowaczyk, M. (2024). Innovative approaches to enhance and measure medication adherence in chronic disease management: a review. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 30, e944605-1.
21. Gifford, A. L., & Groessl, E. J. (2002). Chronic disease self-management and adherence to HIV medications. JAIDS Journal of Acquired Immune Deficiency Syndromes, 31, S163-S166.
https://doi.org/10.1097/00126334-200212153-00016
22. Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research, 17(2), e52.
https://doi.org/10.2196/jmir.3951
23. Hansen, R., Seifeldin, R., & Noe, L. (2007, June). Medication adherence in chronic disease: issues in posttransplant immunosuppression. In Transplantation proceedings (Vol. 39, No. 5, pp. 1287-1300). Elsevier.
24. Ismail, H., Marshall, V. D., Patel, M., Tariq, M., & Mohammad, R. A. (2022). The impact of the COVID-19 pandemic on medical conditions and medication adherence in people with chronic diseases. Journal of the American Pharmacists Association, 62(3), 834-839.
https://doi.org/10.1016/j.japh.2021.11.013
25. Jannah, W., Khoiry, Q. A., Alfian, S. D., & Abdulah, R. (2025). Suitability of Measures of Pharmacy-Based Medication Adherence for Routine Clinical Use Among Patients with Chronic Diseases: A Systematic Review. Patient preference and adherence, 265-278.
26. Jeon, H. O., Chae, M. O., & Kim, A. (2022). Effects of medication adherence interventions for older adults with chronic illnesses: a systematic review and meta-analysis. Osong Public Health and Research Perspectives, 13(5), 328.
https://doi.org/10.24171/j.phrp.2022.0168
27. Kasahun, A. E., Sendekie, A. K., Mekonnen, G. A., Sema, F. D., Kemal, L. K., & Abebe, R. B. (2022). Impact of personal, cultural and religious beliefs on medication adherence among patients with chronic diseases at university hospital in Northwest Ethiopia. Patient preference and adherence, 1787-1803.
28. Kinney, R. L., Lemon, S. C., Person, S. D., Pagoto, S. L., & Saczynski, J. S. (2015). The association between patient activation and medication adherence, hospitalization, and emergency room utilization in patients with chronic illnesses: a systematic review. Patient education and counseling, 98(5), 545-552.
https://doi.org/10.1016/j.pec.2015.02.005
29. Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors contributing to medication adherence in patients with a chronic condition: a scoping review of qualitative research. Pharmaceutics, 13(7), 1100.
30. Ladner, J., El Badrawy, M., Nofal, A., Saba, J., & Audureau, E. (2020). A cohort study of medication adherence among patients with chronic obstructive pulmonary disease in Egypt. NPJ primary care respiratory medicine, 30(1), 31.
https://doi.org/10.1038/s41533-020-0188-9
31. Lauffenburger, J. C., Shrank, W. H., Bitton, A., Franklin, J. M., Glynn, R. J., Krumme, A. A., ... & Choudhry, N. K. (2017). Association between patient-centered medical homes and adherence to chronic disease medications: a cohort study. Annals of internal medicine, 166(2), 81-88.
32. Lavielle, M., Puyraimond-Zemmour, D., Romand, X., Gossec, L., Senbel, E., Pouplin, S., ... & Molto, A. (2018). Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review. RMD open, 4(2).
https://doi.org/10.1136/rmdopen-2018-000684
33. Lee, S., Jiang, L., Dowdy, D., Hong, Y. A., & Ory, M. G. (2019). Effects of the chronic disease self-management program on medication adherence among older adults. Translational behavioral medicine, 9(2), 380-388.
34. Lemay, J., Waheedi, M., Al-Sharqawi, S., & Bayoud, T. (2018). Medication adherence in chronic illness: do beliefs about medications play a role? Patient preference and adherence, 1687-1698.
https://doi.org/10.2147/ppa.s169236
35. Losi, S., Berra, C. C. F., Fornengo, R., Pitocco, D., Biricolti, G., & Federici, M. O. (2021). The role of patient preferences in adherence to treatment in chronic disease: a narrative review. Drug target insights, 15, 13.
36. Marengo, M. F., & Suarez-Almazor, M. E. (2015). Improving treatment adherence in patients with rheumatoid arthritis: what are the options? International journal of clinical rheumatology, 10(5), 345.
https://doi.org/10.2217/ijr.15.39
37. Massot Mesquida, M., De La Fuente, J. A., Andrés Lorca, A. M., Arteaga Pillasagua, I., Balboa Blanco, E., Gracia Vidal, S., ... & Torán-Monserrat, P. (2021). Primary care records of chronic-disease patient adherence to treatment. International journal of environmental research and public health, 18(7), 3710.
38. Napolitano, F., Napolitano, P., Angelillo, I. F., & Collaborative Working Group. (2016). Medication adherence among patients with chronic conditions in Italy. The European Journal of Public Health, 26(1), 48-52.
https://doi.org/10.1093/eurpub/ckv147
39. Neiman, A. B. (2017). CDC grand rounds: improving medication adherence for chronic disease management—innovations and opportunities. MMWR. Morbidity and mortality weekly report, 66.
40. Neiman, A. B., Ruppar, T., Ho, M., Garber, L., Weidle, P. J., Hong, Y., ... & Thorpe, P. G. (2018). CDC Grand Rounds: Improving medication adherence for chronic disease management—Innovations and opportunities. American Journal of Transplantation, 18(2), 514-517.
https://doi.org/10.1111/ajt.14649
41. Ofman, J. J., Badamgarav, E., Henning, J. M., Knight, K., Gano Jr, A. D., Levan, R. K., ... & Weingarten, S. R. (2004). Does disease management improve clinical and economic outcomes in patients with chronic diseases? A systematic review. The American journal of medicine, 117(3), 182-192.
42. Oliveira, C. J., José, H. M. G., & Costa, E. I. M. T. D. (2024). Medication adherence in adults with chronic diseases in primary healthcare: A quality improvement project. Nursing Reports, 14(3), 1735-1749.
https://doi.org/10.3390/nursrep14030129
43. Pages-Puigdemont, N., Mangues, M. A., Masip, M., Gabriele, G., Fernández-Maldonado, L., Blancafort, S., & Tuneu, L. (2016). Patients’ perspective of medication adherence in chronic conditions: a qualitative study. Advances in therapy, 33(10), 1740-1754.
44. Patel, S., Huang, M., & Miliara, S. (2025). Understanding treatment adherence in chronic diseases: challenges, consequences, and strategies for improvement. Journal of Clinical Medicine, 14(17), 6034.
https://doi.org/10.3390/jcm14176034
45. Polsook, R., Supametaporn, P., Suktrakul, S., & Wuttisittikulkij, L. (2026). Self‐Management Technology of Medication Adherence in Patient Chronic Disease: A Systematic Review and Meta‐Analysis. Worldviews on Evidence‐Based Nursing, 23(2), e70137.
https://doi.org/10.1111/wvn.70137
46. Rafii, F., Fatemi, N. S., Danielson, E., Johansson, C. M., & Modanloo, M. (2014). Compliance to treatment in patients with chronic illness: A concept exploration. Iranian journal of nursing and midwifery research, 19(2), 159-167.
47. Ruksakulpiwat, S., Zhou, W., Niyomyart, A., Wang, T., & Kudlowitz, A. (2023). How does the COVID-19 pandemic impact medication adherence of patients with chronic disease? A systematic review. Chronic illness, 19(3), 495-513.
https://doi.org/10.1177/17423953221110151
48. Ruppar, T., Ho, P. M., Garber, L., Weidle, P. J., Iskander, J. K., Thorpe, P., & Laird, S. (2017). Overcoming barriers to medication adherence for chronic diseases.
49. Selvakumar, D., Sivanandy, P., Ingle, P. V., & Theivasigamani, K. (2023). Relationship between treatment burden, health literacy, and medication adherence in older adults coping with multiple chronic conditions. Medicina, 59(8), 1401.
https://doi.org/10.3390/medicina59081401
50. Shahin, W., Kennedy, G. A., & Stupans, I. (2019). The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review. Patient preference and adherence, 1019-1035.
https://doi.org/10.2147/ppa.s212046
51. Shrivastav, P., & Malakar, U. (2024). Exploring Barriers to Medication Adherence Among Patients with Chronic Diseases. Clinical Journal for Medicine, Health and Pharmacy, 2(3), 21-31.
52. Singh, J., Alam, M. S., Malik, A., Tyagi, S. S., Tousib, M., Alam, N., & Jain, A. (2021). Ways to Improve Medication Adherence in Chronic Disease Patients–A Review. J Evolut Med Dental Sci, 10(36), 3171-3178.
https://doi.org/10.14260/jemds/2021/644
53. Tolley, A., Hassan, R., Sanghera, R., Grewal, K., Kong, R., Sodhi, B., & Basu, S. (2023). Interventions to promote medication adherence for chronic diseases in India: a systematic review. Frontiers in public health, 11, 1194919.
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