Abstract
Improving medication adherence can reduce the burden of cardiovascular disease (CVD) in Saudi Arabia and its related healthcare expenses. This study aimed to assess physicians' awareness and knowledge of barriers to medication adherence in cardiovascular patients in Saudi Arabia and to evaluate the strategies they employ in clinical practice to enhance adherence. A sample of Saudi Arabian licensed physicians specializing in CVD participated in an observational cross-sectional investigation. Participants were recruited using convenience sampling method through in-person visits conducted at various healthcare facilities. Using a standardized, peer-reviewed questionnaire spanning areas of knowledge, awareness, and practice, data were gathered. SPSS version 27 was used for statistical analysis; multivariate linear regression was utilized to identify independent factors. A total of 265 physicians participated. Among physicians, 44.9% always asked about medication habits, 26.8% about missed doses, 28.3% discussed illness severity, and 19.2% explained consequences of nonadherence. None consistently addressed side effects, though 46.4% did so frequently. Over half (58.1%) reported that 36% to 65% of patients failed to start therapy after the first prescription. Univariate analysis identified age as associated factors for knowledge, and sex, age, and training for practice. Regression analysis identified age and private work significant independent predictor for knowledge (β = -.05, -.68; P = .01, and .03; respectively), and only training remained a significant independent predictor for practice (β = 8.03, P < .001). Physicians showed modest knowledge with major gaps in practice especially educating patients about side effects and consequences of nonadherence. Knowledge was lower among older physicians and those in private practice, while training was the strongest predictor of better clinical practice, highlighting the need for targeted education and training to improve adherence-related practices.