Prevalence of Medication Non-Adherence among Adults with Chronic Diseases in Gulf Countries: A Systematic Review and Meta-Analysis

Medication non-adherence is a significant global challenge that compromises treatment effectiveness, increases healthcare costs, and contributes to preventable morbidity and mortality among patients with chronic diseases. Although several studies have examined medication adherence in Gulf countries, reported prevalence estimates vary considerably, and no comprehensive synthesis of the evidence currently exists for this region. This systematic review and meta-analysis aims to estimate the pooled prevalence of medication non-adherence among adults with chronic diseases in Gulf countries (Saudi Arabia, Oman, United Arab Emirates, Qatar, Kuwait, and Bahrain). In addition to quantifying prevalence, this review will identify and synthesize factors commonly reported to be associated with medication non-adherence in this population. A comprehensive search of electronic databases will be carried out without year restriction. Eligible observational studies reporting prevalence data will be included. Risk of bias will be assessed using a standardized appraisal tool for prevalence studies. Where appropriate, pooled prevalence estimates will be calculated using a random-effects meta-analysis model, and heterogeneity will be examined through subgroup and sensitivity analyses. Reported associated factors will be synthesized narratively due to expected methodological variability. The findings of this review will provide region-specific evidence to inform clinicians, policymakers, and healthcare systems in the Gulf region, and may guide the development of targeted interventions to improve medication adherence among patients with chronic diseases.