Medication Adherence among Patients with Chronic Diseases in Saudi Arabia

Round 1

Reviewer 1 Report

This is a good study that focuses on an important topic. I have some comments and suggestions which will help strengthen the paper and make it clearer to the readers. The suggestions are as follows:

Line 29: Please put asthma after 21% had heart diseases (larger numbers to smaller numbers).

Line 38: Please rewrite this sentence for clarity. 

Lines 67-70: Consider providing a little more background on medication adherence in Saudi Arabia as that will establish a strong rationale and platform for the rest of the manuscript

Line 81: Would 'over the counter' be an appropriate term for 'non-prescribed' here?

Line 82: Please describe how the sample was selected and the sociodemographic characteristics of the sampling pool.

Lines 87-88: Were these experts clinicians, patients or survey researchers?

Line 94: Can you please provide the questionnaire used in the supplementary materials and reference it here?

Line 96: Please delete 'the' at the beginning of the sentence

Line 100: Please describe the process for data collection in more depth.

Line 102: The last two sentences are repeated in the previous paragraph. Consider deleting at one instance.

Line 108: How many total questionnaires were administered? Please report a %response

Line 108: Was a sample size calculation performed? Please provide specifics about how 239 was considered a sample size representative of the overall population?

Line 204: Please describe this limitation in more detail- why was the onlune survey an issue?

Line 2016: Small sample size is another important limitation. Please add it here.

 

Author Response

Your valuable comments are highly appreciated

In the manuscript - Responses to comments and suggestions were  written in green

Author Response File: Author Response.docx

Reviewer 2 Report

Interesting paper and surely relevant for country knowledge related to non-adherence. Although paper es well structured and presented maybe there is a need of further information for better understanding about research performed.

Main need to know about methodology. We don't know about the way the criteria to select the sample and even we don't know about the number of patients invited to participate. These are crucial aspects in methodology to validate the results. If a patient has to take the same pill 3 times a day for one medical reason, is that patient taking one or 3 medications? That is not clear as well when explaining methods. Perhaps there is a lack of information also about different type of drugs and non-adherence situation. There is aldo a bit confusion when explaining that both prescribed and non-prescribed drugs were taking into account. If we are considering OTC drugs then doctor-patient interaction is different. I would expect a bit more explanation about the way health system works in Saudi Arabia (primary care, prescription patterns, pharmacy role in heath system...)  for a better comprehension 

There are some interesting on the questionnaire of reasons for non-adherence but if most of patients are considering too may drugs a major reason, there is perhaps no point to consider also  ' non specific reason' a major issue. 

Limitations of the study are quite important ( from design to expected conclusions ) and I think they need to be considered all of them . 

Author Response

Your valuable comments are highly appreciated

In the manuscript - Responses to comments and suggestions were  written in green .

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Paper has improved a lot after suggested

modificacions have been adequately included.

I have no more concerns and I think the paper

can be ready for publishing. Perhapps a

minor English language adaptation will benefit 

the final result.