ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Pharmacoepidemiology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1619023
This article is part of the Research TopicPharmacoepidemiology in Chronic DiseasesView all 15 articles
Medication Adherence in Jordanian Patients with Multimorbidity: A Cross-Sectional Mixed-Methods Study in Outpatient Clinics
Provisionally accepted
- 1Al-Ahliyya Amman University, Amman, Jordan
- 2Zarqa University, Zarqa, Zarqa, Jordan
- 3Mutah University, Al Karak, Karak, Jordan
- 4Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Multimorbidity, 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. Methods: A 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. Results: Of 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. Conclusion: This 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.
Keywords: Medication Adherence, multimorbidity, Chronic disease multimorbidity, Polypharmacy, Mixed-methods approach
Received: 27 Apr 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Abed, Abu Assab, Abu Dayyih, Alotaibi and Alsubaie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Anas Abed, Al-Ahliyya Amman University, Amman, Jordan
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.