Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning

Background Managing chronic illness effectively depends not only on treatment availability but also on patients’ ability to adhere to prescribed medications.Objectives This study examined the factors influencing medication adherence among Jordanian adults with long-term conditions, using both tradit...

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Main Authors: Walid Al-Qerem, Anan Jarab, Judith Eberhardt, Salwa Abdo, Lujain Al-sa’di, Razan Al-Shehadeh, Dana Khasim, Ruba Zumot, Sarah Khalil
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2548979
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author Walid Al-Qerem
Anan Jarab
Judith Eberhardt
Salwa Abdo
Lujain Al-sa’di
Razan Al-Shehadeh
Dana Khasim
Ruba Zumot
Sarah Khalil
author_facet Walid Al-Qerem
Anan Jarab
Judith Eberhardt
Salwa Abdo
Lujain Al-sa’di
Razan Al-Shehadeh
Dana Khasim
Ruba Zumot
Sarah Khalil
author_sort Walid Al-Qerem
collection DOAJ
description Background Managing chronic illness effectively depends not only on treatment availability but also on patients’ ability to adhere to prescribed medications.Objectives This study examined the factors influencing medication adherence among Jordanian adults with long-term conditions, using both traditional regression and machine learning methods.Method In this cross-sectional study, patients with chronic conditions completed an online survey that assessed demographic, clinical and behavioural variables, including Health Literacy Questionnaire (HLQ-12) and adherence (MARS-5). Quantile regression and machine learning models were applied.Results A total of 981 patients (63.1% females) were enrolled in the study. Quantile regression showed that higher health literacy, a diagnosis of diabetes or cardiovascular disease, and fewer prescribed medications were positively associated with adherence. In contrast, being married or having public, military or no insurance was linked to lower adherence scores. The Random Forest model achieved the highest predictive accuracy (R2 = 0.38), and SHAP analysis identified health literacy, disease duration and age as the most influential features.Conclusions These findings highlight the need for targeted interventions that address both individual understanding and structural challenges, such as insurance type and treatment complexity. Improving health literacy, simplifying medication regimens, and ensuring equitable healthcare access may help support better adherence in this population. The use of explainable machine learning, alongside conventional statistical approaches, offers new opportunities to improve the understanding and prediction of adherence behaviours in resource-constrained settings.
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spelling doaj-art-b9d5d68f590d4543a1a24f6913e1de672025-08-20T16:02:43ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2548979Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learningWalid Al-Qerem0Anan Jarab1Judith Eberhardt2Salwa Abdo3Lujain Al-sa’di4Razan Al-Shehadeh5Dana Khasim6Ruba Zumot7Sarah Khalil8Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, JordanDepartment of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UKDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanDepartment of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, JordanBackground Managing chronic illness effectively depends not only on treatment availability but also on patients’ ability to adhere to prescribed medications.Objectives This study examined the factors influencing medication adherence among Jordanian adults with long-term conditions, using both traditional regression and machine learning methods.Method In this cross-sectional study, patients with chronic conditions completed an online survey that assessed demographic, clinical and behavioural variables, including Health Literacy Questionnaire (HLQ-12) and adherence (MARS-5). Quantile regression and machine learning models were applied.Results A total of 981 patients (63.1% females) were enrolled in the study. Quantile regression showed that higher health literacy, a diagnosis of diabetes or cardiovascular disease, and fewer prescribed medications were positively associated with adherence. In contrast, being married or having public, military or no insurance was linked to lower adherence scores. The Random Forest model achieved the highest predictive accuracy (R2 = 0.38), and SHAP analysis identified health literacy, disease duration and age as the most influential features.Conclusions These findings highlight the need for targeted interventions that address both individual understanding and structural challenges, such as insurance type and treatment complexity. Improving health literacy, simplifying medication regimens, and ensuring equitable healthcare access may help support better adherence in this population. The use of explainable machine learning, alongside conventional statistical approaches, offers new opportunities to improve the understanding and prediction of adherence behaviours in resource-constrained settings.https://www.tandfonline.com/doi/10.1080/07853890.2025.2548979Medication adherenceJordanhealth literacychronic diseasescardiovascular diseasesrandom Forest
spellingShingle Walid Al-Qerem
Anan Jarab
Judith Eberhardt
Salwa Abdo
Lujain Al-sa’di
Razan Al-Shehadeh
Dana Khasim
Ruba Zumot
Sarah Khalil
Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
Annals of Medicine
Medication adherence
Jordan
health literacy
chronic diseases
cardiovascular diseases
random Forest
title Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
title_full Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
title_fullStr Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
title_full_unstemmed Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
title_short Medication adherence among Jordanian adults with chronic conditions: a combined analysis using regression and machine learning
title_sort medication adherence among jordanian adults with chronic conditions a combined analysis using regression and machine learning
topic Medication adherence
Jordan
health literacy
chronic diseases
cardiovascular diseases
random Forest
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2548979
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