Search Results (56)

Background: Medication adherence is essential for optimal seizure control in epilepsy. However, non-adherence to antiepileptic drugs (AEDs) remains common and contributes to poor clinical outcomes. Evidence on adherence patterns and determinants in Saudi Arabia is limited. This study aimed to evaluate AED adherence and identify factors associated with adherence among patients with epilepsy in Saudi Arabia. Methods: A multicentre cross-sectional study was conducted among patients with epilepsy attending outpatient clinics across multiple regions in Saudi Arabia. Data were collected between January 2023 and June 2025. Medication adherence was assessed using the self-reported 10-item Medication Adherence Rating Scale (MARS). Adherence was categorized as low (0–5), moderate (6–7), or high (8–10). Descriptive statistics summarized participant characteristics. Logistic regression was used to identify factors associated with high adherence, reported as adjusted odds ratios (aORs) with 95% confidence intervals. All analyses were performed using Stata. Results: A total of 534 participants were included. Nearly half reported a seizure during the previous six months (46.4%). High adherence was observed in 58.2% of participants while moderate adherence was reported by 27.5%, and 14.2% had low adherence. The most common adherence barrier was forgetfulness (57.3%). Fear of medication side effects was reported by 27.9% of participants. Seizure occurrence was associated with lower adherence (aOR 0.39, 95% CI 0.26–0.59). Each additional adherence barrier reduced the odds of high adherence (aOR 0.71, 95% CI 0.63–0.80). More reported side effects were also associated with lower adherence (aOR 0.92, 95% CI 0.87–0.97). Participants from the Eastern (aOR 5.06, 95% CI 1.14–22.35) and Central regions (aOR 5.36, 95% CI 1.48–19.38) showed higher adherence than those from the Southern region. Conclusions: Medication adherence among patients with epilepsy in Saudi Arabia remains suboptimal. Modifiable barriers, particularly forgetfulness and treatment side effects, should be addressed. Patient-centred adherence interventions may improve long-term seizure control and treatment outcomes. These findings should be interpreted considering the cross-sectional study design and the use of a self-reported adherence measure. Full article

Background/Objectives: Multiple myeloma (MM) disproportionately affects older adults and racial/ethnic minorities, many of whom face socioeconomic barriers to care. Immunomodulators (IMiDs) are central to MM therapy, but their benefit relies on timely initiation and sustained adherence. In safety-net settings, barriers such as insurance approvals, Patient Medication Assistance Program (PMAP) enrollment, and Risk Evaluation and Mitigation Strategy (REMS) requirements may influence adherence. This study evaluated IMiD adherence during the first two years of therapy among socioeconomically vulnerable MM patients in a large safety-net hospital, with attention to PMAP enrollment and treatment delays. Methods: We conducted a retrospective cohort study of adults (≥18 years) with newly diagnosed MM between October 2010 and January 2022 who initiated lenalidomide or pomalidomide at a safety-net hospital. Adherence was measured using the proportion of days covered (PDC). Delays in initiation were defined as ≥1 month from diagnosis to first IMiD prescription fill. This threshold was selected a priori based on the REMS-mandated 28-day prescription supply limit for lenalidomide and pomalidomide, which establishes a natural monthly treatment cycle; a delay exceeding one full 28-day cycle before therapy initiation is operationally meaningful within the REMS framework. Results: Eighty patients met criteria (mean age 55.1 years; 56.3% Hispanic/Latino; 31.3% African American). Most were unemployed (63.8%), 42.5% uninsured, and 57.5% enrolled in PMAP. Only 12.5% achieved PDC ≥ 80%. Median PDC was higher among PMAP enrollees (0.40 vs. 0.31; p = 0.0293) and transplant-ineligible patients (0.46 vs. 0.27; p = 0.0218). Delays ≥ 1 month occurred in 65% of patients. Conclusions: Adherence to IMiDs was suboptimal in this younger safety-net cohort. Although PMAP improved adherence, program delays may reduce early treatment benefits, underscoring the need for streamlined access and targeted interventions to address both patient- and system-level barriers. Full article

Background/Objectives: The rapid growth of the global aging population, projected to reach 2.1 billion older adults by 2050, presents major challenges for pharmacotherapy and drug delivery. Age-related physiological changes affecting pharmacokinetics and pharmacodynamics, widespread polypharmacy, and functional impairments such as dysphagia, cognitive decline, and sensory or motor limitations reduce the effectiveness and safety of conventional “one-size-fits-all” medication approaches. This review aimed to evaluate the major barriers to effective drug delivery in older adults and to assess emerging patient-centered and technology-driven drug delivery systems designed to improve medication adherence, safety, and therapeutic outcomes in geriatric populations. Methods: A comprehensive narrative review of current literature was conducted focusing on geriatric pharmacotherapy, age-related barriers to medication administration, and advanced drug delivery technologies. The review analyzed evidence regarding modified oral formulations, transdermal systems, long-acting injectables, implantable devices, nanotechnology-based platforms, digital health integrations, pharmacogenomics, biomarker-guided therapy, and deprescribing strategies including STOPP/START criteria and Beers Criteria. Studies addressing polypharmacy, medication adherence, and personalized medicine in older adults were also evaluated. Results: Evidence indicates that older adults experience significant medication-related challenges due to multimorbidity, polypharmacy, and functional decline. Dysphagia affects more than half of nursing home residents, while polypharmacy prevalence reaches up to 86.6% in some populations. Emerging drug delivery technologies demonstrated potential to improve adherence, dosing precision, and patient convenience. Personalized approaches incorporating pharmacogenomics, biomarker-guided treatment, and AI-assisted dosing showed promise for optimizing therapy. However, major limitations remain, including underrepresentation of older adults in clinical trials, limited high-quality evidence supporting many polypharmacy interventions, and insufficient implementation of advanced drug delivery systems in routine clinical practice. Conclusions: Current evidence supports a transition from standardized medication approaches toward flexible, individualized, and patient-centered drug delivery strategies for older adults. Advanced delivery technologies and personalized pharmacotherapy may improve medication safety, adherence, and quality of life in aging populations, although stronger clinical evidence and broader implementation are still needed. Future progress will require interdisciplinary care models, improved geriatric representation in clinical research, and regulatory reforms supporting the integration of innovative drug delivery systems into routine healthcare practice. Full article

Diabetes Mellitus is a chronic metabolic disorder characterized by elevated blood glucose due to defects in insulin secretion or action, or both, leading to serious short- and long-term complications if not effectively managed. However, there is limited qualitative evidence exploring how youths diagnosed with Type 1 Diabetes Mellitus (T1DM) experience disease onset, management, complications, emotional adaptation, and education within the South African public healthcare system. The study aims to investigate the lived experiences of youths living with T1DM in a selected public hospital in Limpopo province, South Africa. The objectives were to explore and describe the lived experiences of youths living with T1DM. A qualitative, explorative, descriptive, and contextual design was used to gain a thorough understanding of the experiences of youths living with T1DM. A non-probability sampling technique was used to select 12 participants using a pre-determined criterion. Data were collected through individual semi-structured interviews using an interview guide. The data were analyzed using Colaizzi’s method, where themes and sub-themes were developed with the inclusion of an independent coder. Measures to ensure trustworthiness and ethical considerations were adhered to throughout the study. The findings revealed that, despite the participants sharing the same diagnosis, they experience multiple interrelated barriers that significantly hindered effective self-care management, such as limited access to diabetic diet, glucometers and supplies, treatment and informational-related barriers, school-related challenges, transportation constraints and inadequate social support. Furthermore, the findings highlighted gaps in early recognition of symptoms, standardized diabetes education, psychosocial support, and continuity of care. The study recommends the need for holistic, patient-centred, and contextualized interventions that do not only address medical management but the socioeconomic, educational, and psychological needs of youths. Full article

Background/Objectives: Dental Practice-Based Research Networks (DPBRNs) bridge the gap between academic research and private dental practice, addressing questions relevant to everyday medical care. Despite their growing scientific output, little research has explored the experiences of practitioners engaged in these networks. Our study therefore aims to investigate these practitioners’ perspectives in order to identify strategies for improving investigator recruitment, training and data quality in future DPBRN studies. Methods: The qualitative methodology was chosen, and our study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Semi-structured interviews were conducted with dentists who had participated in a DPBRNs study and transcribed before being thematically analysed using Braun and Clarke’s framework. MaxQDA 2022 software was used to facilitate coding of the verbatim quotes. Results: Three major themes emerged: (1) obstacles to participation, including time constraints, difficulties in patient recruitment, and a perceived disconnect between academia and private practice; (2) facilitators of engagement, such as strong leadership, logistical support, and a collaborative research environment; and (3) personal benefits, such as skill development, breaking professional routines, and counteracting stereotypes about private practitioners’ involvement in research. Conclusions: The findings align with existing literature on medical Practice-Based Research Networks (PBRNs), highlighting logistical and motivational barriers while also emphasizing the importance of social and professional benefits. Notably, although financial compensation or credits for continuing professional development are frequently cited as motivators for research participation, these were not significant concerns for our participants. This study sheds light on the experiences of health practitioners in PBRNs, offering recommendations to overcome challenges through strategies such as accessible training, practical incentives and collaboration opportunities. Full article

Objectives: Medication adherence in elderly patients is shaped by cognitive, behavioral, systemic, and socioeconomic factors. This review aimed to identify determinants and effective strategies to improve adherence in older adults. Methods: A systematic search of PubMed, Scopus, and ScienceDirect (2015–2025) followed PRISMA 2020 guidelines. From 5116 records, 53 studies met inclusion criteria. Randomized controlled trials were meta-analyzed using standardized mean differences under a random-effects model. Risk of bias in the 10 pooled trials was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using the GRADE framework. Results: Adherence ranged from 25.3% in institutionalized patients to 97.6% in pharmacist-led schizophrenia programs. Cognitive impairment and frailty reduced adherence (54.2%), while caregiver involvement improved rates, especially in dementia and schizophrenia (77.4–97.6%). Socioeconomic barriers, including medication cost, contributed to nonadherence but were mitigated by subsidies. Digital tools enhanced adherence in chronic disease, and machine learning models accurately predicted nonadherence (AUC up to 0.935). Effective interventions—caregiver support, digital platforms, and single-pill regimens—increased adherence by 25–59% and reduced cardiovascular events. The meta-analysis demonstrated a significant pooled effect (Standardized Mean Difference, SMD = 0.71, 95% CI: 0.11–1.54), although heterogeneity was high (I² = 99%). The RoB 2 assessment of the 10 pooled trials identified 2 at low risk, 4 with some concerns, and 4 at high risk of bias; the GRADE certainty of evidence was rated Very Low. Conclusions: Multiple factors, including frailty, cognitive deficits, socioeconomic barriers, regimen complexity, and the level of caregiver support, appear to be consistently associated with medication adherence in older adults. Strategies such as caregiver engagement, digital health tools, regimen simplification, and mental health support may contribute to improved adherence, although effect sizes vary considerably across study contexts. Given the substantial heterogeneity, Very Low certainty of evidence (GRADE), and variable study quality, findings should be interpreted with caution. System-level reforms, financial assistance programs, and culturally tailored approaches may further support adherence, while the successful implementation of digital health solutions will require addressing literacy, accessibility, and integration challenges. Full article

Background: Topical Corticosteroids (TCS) are potent therapeutic agents associated with severe local and systemic adverse effects if misused. In Jordan, the unauthorized supply of TCS for cosmetic purposes and the mismanagement of dermatological conditions remain significant public health concerns. This study utilized a repeated-measures simulated patient (SP) methodology to evaluate community pharmacists’ stewardship of TCS across a spectrum of clinical risks. Methods: A national cross-sectional study was conducted across 380 randomly selected community pharmacies in Jordan. Each pharmacy received four covert visits (N = 1520) corresponding to four distinct clinical scenarios representing different risk levels: cosmetic whitening, acne management, fungal infection, and pediatric diaper rash. The primary outcome was appropriate Practice, defined as the refusal to dispense unsafe medication or the provision of evidence-based alternatives. Results: Stewardship behavior varied significantly by clinical context (p < 0.001). Pharmacists demonstrated a hierarchy of safety, adhering to guidelines most strictly in the Pediatric scenario (82.1% appropriate refusal) but frequently abandoning safety standards in the Cosmetic scenario (30.0% appropriate refusal). Notably, 70.0% of pharmacists dispensed potent steroids for facial whitening, and 26.1% voluntarily offered to compound unauthorized steroid mixtures (Khaltat). In the acne scenario, 52.1% dispensed the contraindicated TCS, while only 37.9% appropriately switched the patient to an evidence-based alternative. In the fungal scenario, 60.0% failed to visually inspect the lesion, leading to a 40.0% rate of inappropriate TCS dispensing. Multivariable regression indicated that pharmacists working in chain pharmacies (aOR: 2.15, 95% CI: 1.68–2.75) and those holding advanced degrees (PharmD/MSc) (aOR > 1.38) were significantly more likely to practice appropriate TCS stewardship. High workload (>200 prescriptions/day) was a significant barrier to safety (aOR: 0.55). Conclusions: Community pharmacists in Jordan exhibited selective TCS stewardship, demonstrating high vigilance for pediatric safety, but widespread illegal practice regarding cosmetic misuse and differential diagnosis that may be unethical. The study results warrant the need for further urgent research to understand why these practices are occurring and how best to address them. Full article

Medication adherence following myocardial infarction (MI) is essential for effective secondary prevention, yet adherence rates remain suboptimal. Healthcare professionals (HCPs) are central to promoting adherence through clinical decision-making, patient education, and ongoing behavioural support. Understanding how HCPs perceive and experience the factors’ influencing adherence is key to developing effective, context-specific interventions. This study explored HCPs’ perspectives on medication adherence post-MI and identified behavioural determinants influencing medication management across the care pathway. A qualitative descriptive study was conducted using semi-structured interviews with HCPs in the southwest of Ireland. Participants included hospital pharmacists, community pharmacists, general practitioners (GPs), cardiologists, and nurses, recruited through purposive, convenience, and snowball sampling. Interviews were recorded, transcribed verbatim, and analysed using directed content analysis guided by the Theoretical Domains Framework (TDF). Twelve HCPs (eight female) were interviewed between December 2024 and May 2025, including four pharmacists, two GPs, three cardiologists and three nurses. Interviews lasted 30–50 min (mean 41 min). Analysis identified 15 facilitators, 13 barriers, and 7 dual-role determinants across 10 TDF domains. Novel contributions include demonstrating how HCPs’ real-world experiences contextualise adherence issues in the distinct post-MI setting characterised by abrupt care transitions, polypharmacy, and emotional vulnerability and identifying where HCPs feel most constrained and where their expertise could directly inform targeted intervention design. HCPs’ insights reveal complex, context-specific behavioural determinants influencing post-MI medication adherence and highlight the need for multidisciplinary, tailored, and system-level solutions. Enhancing collaboration, supporting patient-centred communication, and addressing resource barriers could empower HCPs to deliver more effective, personalised adherence support and inform the development of targeted intervention strategies. Full article

Background/Objectives: Older adults often face nutrition challenges due to mobility issues, chronic conditions, and limited access to adequate nutrition. Digital and technology-based interventions, including those with nutrition education, nutrition counseling and Medically Tailored Meals [MTMs], can help address these barriers. However, the extent and characteristics of such programs in the United States remain unclear. This scoping review aimed to map the existing evidence on digital and technology-based (“digi-tech”) nutrition interventions for older adults in the United States, with particular attention to the presence, characteristics, and gaps related to MTMs. Methods: This scoping review followed the PRISMA-ScR framework to map existing evidence on technology-enabled nutrition care interventions for older adults aged ≥ 60 years in the United States. Systematic searches were conducted across multiple databases, yielding 18,177 records. Following title and abstract screening, full-text review, and eligibility assessment, 16 intervention studies were included. Study designs comprised randomized controlled trials, quasi-experimental and non-randomized studies, mixed-methods feasibility studies, pilot studies, and one retrospective longitudinal cohort study. Data were extracted on study design, population characteristics, intervention components, technology modalities, outcomes, feasibility, acceptability, and reported barriers. Results: Interventions varied in duration [8 weeks to ≥12 months] and content. Foci ranged from remote nutrition education and mobile app-based tracking to multicomponent interventions integrating exercise, nutrition counseling, health literacy, and meal delivery. Telehealth was the most commonly used technology modality, followed by mobile health applications, wearable devices, and online educational platforms. Most interventions reported high feasibility and acceptability, with improvements in diet quality, adherence to healthy eating patterns, clinical measures such as HbA1c and blood pressure, and functional performance. Common implementation barriers included declining technology use over time, digi-tech literacy, and access to devices or the internet. Notably, no studies evaluated a digi-tech-based MTMs intervention exclusively for older adults in the U.S. Conclusions: Digital and technology-based nutrition interventions show promise for improving dietary and health outcomes in older adults, but there is insufficient empirical evidence. Future research might develop and evaluate hybrid digi-tech intervention models that leverage the potential of digi-tech tools while addressing barriers to technology adoption among older adults. Full article

Background: Vitamin E has been studied for its role in reducing the growth of colorectal cancer (CRC). CRC is a worldwide health concern. A meta-analysis reported that CRC patients have a lower concentration of serum vitamin E, suggesting it to be a risk factor. Although rodent models are widely used in disease research, their application in studying vitamin E as a preventive or therapeutic agent in CRC is not well characterized. To address this gap, we conducted a scoping review to examine the available evidence, adhering to the PRISMA-ScR checklist. Methods: We searched PubMed, Google Scholar, Scopus, and Web of Science (WoS) for full-text English original articles published before May 2024, using Medical Subject Headings (MeSH) terms and free text. The following search string strategy was applied: (Vitamin E OR tocopherol$ OR tocotrienol$) AND (Colo$ cancer OR colo$ carcinoma) AND (Rodentia OR mouse OR Rodent$ OR mice OR murine OR rats OR guinea OR rabbit OR hamsters OR Animal model OR Animal testing OR animals) AND (neoplasm$ OR “tumor mass” OR tumor volume OR tumor weight OR tumor burden). Data were charted into five categories using a standardized, pretested form. The charted data were synthesized using descriptive and narrative methods. Conclusions: This study highlights that γ- and δ-tocopherols, as well as δ-tocotrienol and its metabolites, were reported to reduce tumor volume and formation in various rodent models. While these results are promising, this scoping review identifies a need for further research to address translational barriers such as dosing, bioavailability, and long-term safety before clinical application. Full article

Objectives: The study aims to assess the strategies used to estimate antimicrobial consumption (AMC) and the barriers encountered in data collection. It also addresses the perception about AMC based on the World Health Organization (WHO) definition. Methodology: The qualitative study adhered to the standard consolidated criteria for reporting qualitative studies (COREQ) guidelines. It involved stakeholders from diverse sectors, i.e., regulatory bodies, the pharmaceutical industry, international health organizations, policy experts, medical professionals, veterinary doctors, and academia (nursing, medicine, and pharmacy). A total of 37 in-depth interviews were conducted using a semi-structured interview schema. The interviews were recorded and transcribed verbatim. Codes were generated afterward and organized into themes. Results: Data analysis yielded five themes consisting of (i) Perception about Antimicrobial Consumption, AWaRe (Access, Watch, Reserve) classification and related terms, (ii) Antimicrobial Consumption: Policy Design, (iii) Data management and record keeping for the Estimation of Antimicrobial Consumption, (iv) Levels of Estimation for Antimicrobial consumption and Organizations, and (v) Challenges and suggested solutions in estimation of AMC: One health approach is the way forward. Conclusions: The study concluded that AMC and AMR are two sides of the same coin. The solution to AMR and excessive AMC is to re-evaluate the policy and implement legislation strictly. Efforts focused on irrational prescribing and unsupervised OTC sales of antimicrobials. This will help in reducing the consumption of broad-spectrum antimicrobials. Full article

Pediatric drug delivery presents unique challenges due to physiological and pharmacological differences across age groups, requiring specialized formulation approaches beyond simple dose adjustments of adult medications. This review synthesizes recent advances in polysaccharide-based pediatric drug delivery and highlights novel findings that may accelerate clinical translation. It summarizes how chitosan, alginate, hyaluronic acid, dextran, modified starches, and other polysaccharides are engineered into nanoparticles, hydrogels, films, and orodispersible/mini-tablet formulations to improve stability, bioavailability, taste masking, and controlled release across neonates to adolescents. These systems can accommodate developmental variations in absorption, distribution, metabolism, and excretion processes across pediatric subpopulations, with particular emphasis on oral and alternative administration routes. Evidence supporting unexpectedly high acceptability of mini-tablets, successful integration of modified polysaccharides in 3D-printed personalized low-dose therapies, and the emergence of blood–brain barrier-penetrating and RGD-functionalized polysaccharide nanocarriers for pediatric oncology are emphasized as novel, clinically relevant trends. This review also addresses regulatory considerations, safety profiles, and future perspectives. By integrating developmental insights with innovative formulation strategies, polysaccharide polymers offer promising solutions to improve medication adherence, safety, and efficacy across the pediatric age spectrum. Full article

Androgenetic alopecia (AGA), the most common form of hair loss, imposes considerable psychosocial and medical burdens. Current topical treatments are limited by suboptimal efficacy, slow onset, side effects, and poor patient adherence. Although numerous reviews have explored natural plant-based strategies for managing AGA, most offer fragmented evidence with limited systematic correlation between mechanistic studies and clinical outcomes concerning single plant constituents. This review critically synthesizes recent pharmaceutical advances in AGA therapy, with a focus on the synergistic potential of multifunctional plant extracts integrated with nanotechnology enhanced cutaneous delivery systems. We begin by examining the mechanistic basis of AGA pathogenesis and the limitations of existing treatments to identify unmet therapeutic needs. Next, we systematically evaluate plant extracts supported by robust in vitro, in vivo, and clinical evidence for their anti-androgenic, anti-inflammatory, antioxidative, and anti-apoptotic properties. Finally, we address key biopharmaceutical challenges in transdermal delivery for AGA and discuss how nanocarriers can overcome these barriers to improve local drug bioavailability and target specificity. By bridging phytochemistry and nanomedicine, this review provides novel insights and a pharmaceutics-oriented framework aimed at developing safer, more effective, and patient-compliant topical therapies for AGA. Full article

Background: Hypertension is a major global public health problem whose prevalence is increasing across the world. In consideration of this, there is insufficient understanding of the barriers that hinder the taking of anti-hypertensive medication among patients. In this regard, the aim of this study was to analyze the possible barriers undermining adherence to anti-hypertensive medication among patients in private healthcare in Edenvale, South Africa. Methodology: This study used an exploratory cross-sectional research design within which quantitative data were collected through an online survey on a sample of randomly selected hypertensive patients attending private healthcare facilities in Edenvale. Participation in this study was voluntary, and informed consent was sought from each participant. Anonymity was assured during data collection through the de-identification of respondents and any data about them. The collected data were subjected to descriptive statistical analysis. Results: One hundred and twenty-two patients participated in this study. From this, 34.4% of participants revealed that lack of awareness was a barrier to a very small extent. Forgetfulness was a possible barrier to adherence to a large extent amongst 16.4% of participants, and 26.2% of the respondents had, to a large extent, doubts about their hypertension diagnosis. However, 42.6% revealed that side effects and difficulty taking medication whilst away from home (47.5%) were a barrier to a small extent. The fear of side effects (19.7%), interference of alcohol or drug use (29.5%) were challenges to a moderate extent. Conclusions: The findings of this study support that hypertensive patients in private healthcare encounter financial constraints, occasionally forget to take their medication, doubt their hypertension diagnosis, and lack awareness about the benefits of taking anti-hypertensive medication. This may be compounded by patients finding the anti-hypertensive medication regimen too complicated, feeling overburdened by having to take too many pills every day, the complexity of the medication regimens, perceived incorrect diagnosis, and lack of social support from family and friends. Understanding the extent of the barriers encountered by patients in taking anti-hypertension medication may help address adherence challenges, which may help improve health outcomes and lessen the burden on health systems in pursuing Sustainable Development Goal 3 and universal health coverage. Full article

Introduction: Low medication adherence and low hypertension control are a public health challenge, particularly in low- and middle-income countries (LMICs). Healthcare system- and patient-related barriers hinder the successful management of hypertension. This study aimed to identify the perceptions of barriers and facilitators to hypertension management among health system stakeholders in Santander, Colombia. Materials and Methods: We conducted a qualitative, phenomenological, and interpretative study, comprising five focus groups, to explore the barriers and facilitators to managing people with hypertension. Each focus group was formed by stakeholders from territorial entities, healthcare insurers, or healthcare providers. Meetings were held between December 2022 and February 2023. The sessions were recorded and transcribed using NVivo Transcription and analyzed using NVivo version 1.6.1. Results: Seven categories of barriers and facilitators were identified: strategies, resources, access, risk assessment, cross-sector collaboration, articulation, and stewardship. Of these categories, articulation and stewardship emerged as the main barriers, as revealed through axial coding and cluster analysis, which highlighted deficiencies in stewardship practices, a lack of clear objectives, and misalignment with public policy frameworks. Conclusions: Multisectoral actions extending beyond healthcare providers and aimed at improving coordination and intersectoral collaboration are essential for enhancing hypertension control in LMICs, such as Colombia. Addressing social determinants and strengthening primary healthcare through community-based strategies are critical, making stewardship and improved access key priorities. Full article