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Medication Therapy Management in Healthcare
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Medication Therapy Management in Healthcare

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 December 2026 | Viewed by 8924

Special Issue Editors

Dr. Wubshet Tesfaye

E-Mail Website
Guest Editor
School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane 4072, Australia
Interests: chronic kidney disease; medication appropriateness index; medication regimen complexity index; the elderly
Special Issues, Collections and Topics in MDPI journals
Dr. Akshaya Srikanth Bhagavathula

E-Mail Website
Guest Editor
Department of Public Health, North Dakota State University, Fargo, ND, USA
Interests: public health; technology; health promotion; disease prevention; adherence; reproductive health; chronic diseases; epidemiology; biostatistics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Medications are crucial interventions not only for treating various disease conditions but also for preventing disease progression, morbidity and mortality. Medication therapy management or medication review is a strategy widely employed by pharmacists and other health workers to optimize drug therapy with the goal of improving therapeutic outcomes for patients. It comprises different components, such as comprehensive medication review, identifying and addressing potentially inappropriate medications and medication-related needs, developing a pharmaceutical care plan, and identifying and addressing patient monitoring, referral and education requirements.

This Special Issue aims to produce a robust and unique set of evidence on medication therapy management or medication review models in different settings and across the healthcare continuum, innovative approaches used to implement those models, and understanding the effectiveness of such models in improving health, patient-reported, and economic outcomes.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) the following:

  • Medication therapy management approaches in chronic conditions, such as diabetes, hypertension, cardiovascular conditions, and chronic kidney disease.
  • Effectiveness of medication therapy management or medication review models.
  • Cost-effectiveness of medication therapy management or medication review models.
  • Innovative solutions to improve the effectiveness of medication therapy management.
  • Multidisciplinary medication review models (mainly focusing on those containing pharmacists) to improve therapeutic drug outcomes.

I look forward to receiving your contributions.

Dr. Wubshet Tesfaye
Dr. Akshaya Srikanth Bhagavathula
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic kidney disease
  • medication appropriateness index
  • medication regimen complexity index
  • the elderly

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

20 pages, 248 KB  
Article
Knowledge Gaps and Systemic Challenges in Antidepressant Prescribing: Insights from Jordanian Psychiatry Practice
by Bayan Abdulhaq, Walid Sarhan, Mohammed Saadeh, Seif Alkayid, Dana Tahseen Libzo, Mohammad Sadaqa and Latefa Ali Dardas
Healthcare 2025, 13(22), 2954; https://doi.org/10.3390/healthcare13222954 - 18 Nov 2025
Cited by 1 | Viewed by 1196
Abstract
Background: Antidepressant medications are the cornerstone of depression treatment worldwide, playing a central role in reducing the burden of depressive disorders. Their appropriate use is particularly important in low- and middle-income countries (LMICs), where the prevalence of mental health conditions is high [...] Read more.
Background: Antidepressant medications are the cornerstone of depression treatment worldwide, playing a central role in reducing the burden of depressive disorders. Their appropriate use is particularly important in low- and middle-income countries (LMICs), where the prevalence of mental health conditions is high and health systems face increasing demand. Despite the clinical importance of antidepressants, limited evidence exists on how psychiatrists in LMICs prescribe these medications. Jordan, a middle-income country with a growing mental health burden, provides a valuable case study for understanding prescribing patterns and identifying areas for improvement. Objectives: This study examined (1) the knowledge, attitudes, and prescribing practices of Jordanian psychiatrists regarding antidepressant medications, and (2) the perceived challenges hindering optimal prescribing. Methods: A mixed-methods design was employed. Quantitatively, a cross-sectional survey was administered to licensed psychiatrists in Jordan (n = 108; response rate 79.4%). The instrument was adapted from previously published tools on psychotropic prescribing practices and refined using international guidelines and recent reviews on antidepressant use. Qualitatively, semi-structured interviews were conducted with a purposive sample of four psychiatrists to explore systemic, clinical, and contextual barriers to antidepressant prescribing. Survey data were analyzed using descriptive statistics and regression analyses, while interview transcripts were subjected to thematic analysis. Results: Although psychiatrists demonstrated a reasonable understanding of antidepressant pharmacology, important gaps were evident. Only one-third (34.3%) recognized Ministry of Health (MOH) guidelines, while nearly four in ten (37.4%) felt international guidelines did not fully apply to Jordan’s population. Laboratory monitoring for metabolic side effects was inconsistently applied, with just 17.6% always requesting such tests and 11.1% never doing so. Consultation with internal medicine for patients on multiple medications was not routine, reported as “sometimes” by 69.4% of psychiatrists. Attitudes toward prescribing reflected caution, particularly in managing pregnant or lactating women, where only half (51.0%) supported discontinuation and three-quarters (75.9%) preferred dose or drug adjustment. Early-career psychiatrists showed lower engagement, as knowledge and attitude scores were significantly higher among those with 11–20 years of experience compared to those with ≤10 years (p < 0.001). Overall, the findings highlight uneven application of evidence-based practices, reliance on personal clinical judgment, and limited engagement with national standards. Conclusions: Although safety and patient outcomes are valued, systemic, clinician, and patient-related barriers constrain optimal practice. Strengthening national guideline dissemination, ensuring medication access, and supporting continuing professional development could improve prescribing practices in Jordan and similar LMIC contexts. Full article
(This article belongs to the Special Issue Medication Therapy Management in Healthcare)
10 pages, 352 KB  
Article
Assessing Patient Understanding and Adherence to Preoperative Medication Advice Provided in Pre-Admission Clinic
by Alison Tse, Yasmin Baghdadi, Phan Tuong Van Nguyen, Rand Sarhan, Vivek B. Nooney, Wejdan Shahin and Andrew Vuong
Healthcare 2025, 13(19), 2429; https://doi.org/10.3390/healthcare13192429 - 25 Sep 2025
Cited by 1 | Viewed by 1748
Abstract
Background: Appropriate medication management before surgery is essential to minimise perioperative risk. Patient adherence to preoperative medication advice demonstrates considerable variability and is influenced by multiple interacting factors. This study assessed patient understanding and adherence to preoperative medication advice provided in the Pre-Admission [...] Read more.
Background: Appropriate medication management before surgery is essential to minimise perioperative risk. Patient adherence to preoperative medication advice demonstrates considerable variability and is influenced by multiple interacting factors. This study assessed patient understanding and adherence to preoperative medication advice provided in the Pre-Admission Clinic (PAC) and identified factors contributing to non-adherence. Methods: A cross-sectional survey study was conducted over 12 weeks in 2022 at a tertiary hospital. Adult patients scheduled for elective surgery who received preoperative medication advice in PAC were surveyed on the day of surgery. Data collected included demographics, clinical characteristics, adherence, reasons for non-adherence, and communication preferences. Descriptive and inferential statistics were used for analysis. Results: Of 156 participants, 91 (58.3%) adhered to medication advice, while 65 (41.7%) did not. Common reasons for non-adherence included forgotten advice (35.4%), misunderstood advice (33.8%), and intentional deviation due to surgery (18.5%). Non-adherence rates were highest for NSAIDs (50.0%) and P2Y12 inhibitors (45.5%). Two surgeries were cancelled due to the delayed cessation of anticoagulants. Non-adherence was significantly associated with a greater number of medications requiring perioperative management (p = 0.004) and a longer duration between PAC and surgery (p = 0.010). Most non-adherent patients (64.7%) preferred a combination of verbal and written advice. Conclusions: A substantial proportion of patients were non-adherent to preoperative medication advice, often due to unclear communication or a lack of understanding of the clinical rationale for the advice. Multimodal strategies, including written or digital reinforcement of verbal advice, multidisciplinary collaboration, and patient-centred education, may improve adherence and reduce preventable cancellations. Future studies should evaluate the impact of these interventions. Full article
(This article belongs to the Special Issue Medication Therapy Management in Healthcare)
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16 pages, 1441 KB  
Article
Adherence Barriers, Patient Satisfaction, and Depression in Albanian Ambulatory Patients
by Sonila Qirko, Vasilika Prifti, Emirjona Kicaj, Rudina Cercizaj and Liliana Rogozea
Healthcare 2025, 13(14), 1707; https://doi.org/10.3390/healthcare13141707 - 15 Jul 2025
Cited by 3 | Viewed by 1619
Abstract
Background: Medication adherence is essential for managing chronic conditions, while non-adherence remains a widespread issue, leading to poorer health outcomes and higher healthcare costs. This study aimed to identify key adherence barriers, explore their relationship with patient satisfaction, and assess their impact on [...] Read more.
Background: Medication adherence is essential for managing chronic conditions, while non-adherence remains a widespread issue, leading to poorer health outcomes and higher healthcare costs. This study aimed to identify key adherence barriers, explore their relationship with patient satisfaction, and assess their impact on overall well-being among ambulatory patients in Albania. Methods: A cross-sectional study was conducted in three public urban health centers in Vlora, Albania, between November 2024 and January 2025. A total of 80 ambulatory patients were recruited using convenience sampling. Data were collected through face-to-face interviews using validated questionnaires, including the Adherence Barriers Questionnaire (ABQ), the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), and the Patient Health Questionnaire (PHQ-9) for depression screening. Results: The study included 80 ambulatory patients (mean age 66.7 years; 48.7% female), predominantly diagnosed with diabetes (42.5%) and rheumatic diseases (36.3%). All participants reported at least one adherence barrier, with 92.5% experiencing multiple barriers. The most common were financial burden (91.3%) and fear of side effects (77.5%). A significant positive correlation was found between adherence barriers and depression severity (ρ = 0.518, p < 0.0001), while patient satisfaction did not significantly influence adherence barriers (ρ = −0.217, p = 0.053) or depression severity (ρ = −0.004, p = 0.969). Multiple regression analysis showed that higher depression severity (p = 0.0049) was significantly associated with greater adherence barriers, while postgraduate education was associated with fewer barriers (p = 0.0175). Conclusions: Financial burden, fear of side effects, and psychological distress are key barriers to adherence among Albanian ambulatory patients. Although there are limitations inherent to the cross-sectional design and modest sample size, our findings highlight the potential benefit of routine mental health screening, targeted financial support, and improved patient education on medication management within primary care. These insights may help inform future research and interventions aimed at enhancing adherence and overall well-being. Patient satisfaction did not significantly impact adherence or depression. Targeted interventions focusing on financial support, mental health care, and patient education are needed to improve adherence and patient well-being. These findings underscore the need for integrated mental health and adherence support strategies within routine primary care services. Full article
(This article belongs to the Special Issue Medication Therapy Management in Healthcare)
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13 pages, 1730 KB  
Article
Self-Study-Based Informed Decision-Making Tool for Empowerment of Treatment Adherence Among Chronic Heart Failure Patients—A Pilot Study
by Lea Iten, Kevin Selby, Celine Glauser, Sara Schukraft and Roger Hullin
Healthcare 2025, 13(6), 685; https://doi.org/10.3390/healthcare13060685 - 20 Mar 2025
Viewed by 1166
Abstract
Background: Adherence to drug prescriptions is often suboptimal among heart failure (HF) patients. Informed decision-making may improve patients’ adherence to HF drug prescriptions. Aims of the study: We aimed to test whether a self-study-based informed decision-making tool could improve adherence to drug prescriptions [...] Read more.
Background: Adherence to drug prescriptions is often suboptimal among heart failure (HF) patients. Informed decision-making may improve patients’ adherence to HF drug prescriptions. Aims of the study: We aimed to test whether a self-study-based informed decision-making tool could improve adherence to drug prescriptions among ambulatory HF patients. Methods: A tool and a statement-based questionnaire were developed to evaluate drug adherence willingness based on COMPAR-EU recommendations. The test group (n = 40) was exposed to the tool + questionnaire; controls (n = 40) answered the questionnaire only. Agreement with statements of the questionnaire was graded on a scale of 0 to 4 points, reflecting no to full agreement. Results: The median age of controls was younger (56 vs. 61 years; p = 0.04); test and control group patients did not differ across other parameters (always p > 0.05). Patients in both groups agreed that “HF is a life-long disease” (3.5 vs. 4; p = 0.19) and that “only life-long drug treatment provides benefit” (4 vs. 4; p = 0.22). More test group patients confirmed improved comprehension of HF disease (3 vs. 2; p = 0.03) and greater acceptance that “achievement of benefit asks for a combination of HF drugs” (4 vs. 3; p = 0.009) and “daily intake” (4 vs. 3; p = 0.004). In test group patients, questions remained, resulting in less agreement that “all aspects of my heart disease” are understood (1 vs. 3; p < 0.001). Willingness to adhere to HF-drug treatment was not different between the groups (3 vs. 3.5; p = 0.28). Conclusions: The self-study-based informed decision-making tool improved the comprehension of HF and the need for HF treatment, but did not improve willingness to adhere since questions remained unanswered. Full article
(This article belongs to the Special Issue Medication Therapy Management in Healthcare)
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9 pages, 243 KB  
Article
Medication Regimen Complexity and Patient-Centred Outcomes in Patients Undergoing Peritoneal Dialysis
by Jing Xin Goh, Kamal Sud, Wubshet Tesfaye, Connie Van, Shrey Seth, Surjit Tarafdar and Ronald L. Castelino
Healthcare 2024, 12(21), 2121; https://doi.org/10.3390/healthcare12212121 - 24 Oct 2024
Cited by 1 | Viewed by 2305
Abstract
Background: Although patients undergoing peritoneal dialysis (PD) typically have complex treatment needs, the effect of medication regimen complexity on patient outcomes has not been thoroughly evaluated. This study aims to quantify medication regimen complexity and evaluate patient-centred outcomes including medication adherence and its [...] Read more.
Background: Although patients undergoing peritoneal dialysis (PD) typically have complex treatment needs, the effect of medication regimen complexity on patient outcomes has not been thoroughly evaluated. This study aims to quantify medication regimen complexity and evaluate patient-centred outcomes including medication adherence and its determinants in patients undergoing PD. Methods: This study combined a retrospective audit of baseline data with a prospective evaluation of patient-related outcomes among patients undergoing PD at a large metropolitan dialysis centre in Australia. Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI), while patient outcomes were evaluated with validated self-reported questionnaires, including the 4-item Morisky–Green–Levine Scale (MGLS), EQ-5D-5L and EQ VAS. Results: A total of 131 patients participated [median age 67 (IQR 57–74) years]. Patients on PD were found to have complex medication regimens with an average MRCI score of 28.6 ± 11.4. Over half of the participants were deemed to be adherent to their prescribed medications as measured by the MGLS (n = 79; 60.3%). Male participants were more likely to be non-adherent to medications compared to female participants (OR 2.465; 95% CI 1.055–5.759). Participants with higher serum phosphate levels were 2.5 times more likely to report non-adherence to their medications (OR 2.523; 95% CI 1.247–5.104), while a higher health-related quality of life (HRQoL) was associated with medication adherence (OR 0.151, 95% CI 0.031–0.732). Conclusions: Patients on PD are prescribed complex medication regimens in addition to PD treatments that they perform at home. Patients on PD who were adherent to their medications had significantly better outcomes in terms of HRQoL and serum phosphate levels compared to non-adherent patients. Full article
(This article belongs to the Special Issue Medication Therapy Management in Healthcare)
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