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Community pharmacists’ strategies and barriers in supporting medication adherence in Saudi Arabia: a cross-sectional study

Year: 2026

Type: article

Abstract: Background: Community pharmacists are well positioned to identify medication non-adherence and support appropriate medication use. However, evidence regarding their adherence-related activities and perceived barriers in Saudi Arabia remains limited. Objectives: This study examined community pharmacists' self-reported strategies for identifying medication non-adherence and supporting medication use, their attitudes and perceived barriers, and factors associated with their engagement in these activities. Methods: A cross-sectional survey was conducted among licensed community pharmacists from all five regions of Saudi Arabia between September and November 2025. A structured questionnaire adapted from previously published instruments assessed identification and support strategies, attitudes, perceived barriers, and participant characteristics. Data were analyzed using descriptive statistics, principal component analysis, and multiple linear regression. Results: Of 681 pharmacists invited, 382 responded (56.1%), and 345 eligible and complete responses were analyzed. Common identification approaches included the combined MEMS-or-pill-count item (50.8% reported using it at least 75% of the time), assessment of patients' medication response (50.1%), and review of refill records (47.2%). Frequently reported support strategies included promoting self-monitoring (59.7%), using patient-friendly labeling (58.8%), and simplifying medication regimens (57.7%). Major perceived barriers included lack of private consultation areas (49.6%), time constraints (45.8%), limited clinical information (44.1%), and poor patient health literacy (40.6%). In the adjusted analysis, working ≥40 h per week was associated with a lower support-strategy score, whereas employment in a chain pharmacy was associated with a higher score. No examined variable was significantly associated with the identification-strategy score. Conclusion: Community pharmacists reported using several practical adherence-related strategies while experiencing important structural and informational barriers. Workplace characteristics were associated with their reported support activities; however, the cross-sectional design does not permit causal inference or establish improvements in patient adherence or clinical outcomes.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1962692

Authors: Fahad Alzahrani, Faris S. Alnezary, Zikria Saleem, Masaad Saeed Almutairi

Institutions: Taibah University, Qassim University

Language: English

Topic: Medication Adherence and Compliance

Subfield: Family Practice

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801