Abstract
BACKGROUND: Medication non-adherence is a significant barrier to optimal treatment goals. The study explores the association between subjective well-being (SWB) and medication adherence among Lebanese individuals with multiple chronic diseases and identifies additional factors that may influence adherence in this population. METHODS: An exploratory, cross-sectional study was conducted for three months at six community pharmacies. Adherence was assessed using the Adherence to Refills and Medication Scale Arabic Lebanese Version (ARMS-A). The SWB was measured using the Arabic Scale of Happiness (ASH), Love of Life Scale (LLS), Arab Hope Scale (AHS), and Satisfaction with Life Scale (SWLS). Spearmen's Rho correlation analyzed the association between ARMS-A and SWB constructs. Binary logistic regression identified predictors of adherence among individuals with chronic diseases and on multiple chronic medications. RESULTS: Of 400 participants, 106 (26.5 %) with a 95 % CI, 0.22-0.31, were adherent. Lower medication adherence (reflected in higher ARMS-A scores) was associated with lower SWB (p = 0.01). Multivariate analysis showed that lower education (OR = 2.21, 95 % CI, 1.01-4.81), lack of a specific diet (OR = 1.64, 95 % CI, 1.01-2.69), and frequent hospital and/or emergency visits (OR = 3.29, 95 % CI, 1.75-6.17 for 2 visits; OR = 2.71, 95 % CI, 1.43-5.14 for ≥3 visits) significantly increased the odds of non-adherence to chronic treatment. However, higher income (OR = 0.06, 95 % CI, 0.01-0.38), healthcare provider occupation (OR = 0.42, 95 % CI, 0.21-0.48), and having diabetes mellitus (OR = 0.59, 95 % CI, 0.36-0.96) correlated with better adherence. CONCLUSION: A significant portion of participants failed to adhere to their prescribed chronic medications, influenced by multicomplex socioeconomic, psychological, and health-related factors. These findings demonstrate the need for culturally-tailored, pharmacist-led interventions to improve medication adherence and overall health outcomes.