title: Evaluation and implementation of behavioral and educational tools that improves the patients' intentional and unintentional non-adherence to cardiovascular medications in family medicine clinics.
abstract: OBJECTIVE
  There are limited number of studies describing the reasons and interventions of non-adherence to cardiovascular medications in United Arab Emirates (UAE). We aimed to implement and evaluate the behavioral and educational tools that indicate the reasons of non-adherence in patients with cardiovascular diseases and improve patient's adherence to their cardiovascular medications.
  
  
  METHODS
  In this prospective interventional study, we recruited patients (n = 300) with cardiovascular diseases from three family medicine clinics in Al Ain, UAE in 2010. We assessed patients' responses to a validated brief medication questionnaire (BMQ).
  
  
  RESULTS
  At the end of the study, we observed a significant improvement in adherence. When we compared pre- and post-interventions, the mean (± standard deviation, SD) score for non-adherence to current regimen were 4.1 ± 0.2 vs. 3.0 ± 0.3 (p = 0.034); indication of negative believes or motivational barriers scores was 1.8 ± 0.4 vs. 0.9 ± 0.1 (p = 0.027); the indication of recall barrier scores was 1.6 ± 0.1 vs. 0.8 ± 0.1 (p = 0.014); and the indication of access barrier scores was 1.6 ± 0.2 vs. 0.7 ± 0.2 (p = 0.019). Mean blood pressure, fasting blood glucose, glycosylated hemoglobin, low density lipoprotein and postprandial blood glucose decreased significantly (p < 0.01) post-intervention.
  
  
  CONCLUSIONS
  We reported that implemented multifaceted tools targeting patients, provider and healthcare system have improved the adherence to cardiovascular medications. Our interventions managed to improve patients' clinical outcome via improving adherence to prescribed cardiovascular medications.
authors.affiliation: College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), United Arab Emirates.
authors.forename: Abdulla
authors.initials: A
authors.lastname: Shehab
authors.affiliation: College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), United Arab Emirates; Al-Ain Hospital, Abu Dhabi Health Services Company (SEHA), Al-Ain, United Arab Emirates.
authors.forename: Asim Ahmed
authors.initials: AA
authors.lastname: Elnour
authors.affiliation: College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), United Arab Emirates.
authors.forename: Shirina Al
authors.initials: SA
authors.lastname: Swaidi
authors.affiliation: University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia.
authors.forename: Akshaya Srikanth
authors.initials: AS
authors.lastname: Bhagavathula
authors.affiliation: Ajman University of Sciences and Technology, Ajman, United Arab Emirates.
authors.forename: Farah
authors.initials: F
authors.lastname: Hamad
authors.affiliation: College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), United Arab Emirates.
authors.forename: Omar
authors.initials: O
authors.lastname: Shehab
authors.affiliation: Al-Ain Hospital, Abu Dhabi Health Services Company (SEHA), Al-Ain, United Arab Emirates.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: AbuMandil
authors.affiliation: Charles University, Hradec Kralove, Czech Republic.
authors.forename: AboBakr
authors.initials: A
authors.lastname: Abasaeed
authors.affiliation: Ministry of Health, Nyala, South Sudan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Dahab
authors.affiliation: Tawam Hospital, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates.
authors.forename: Naama Al
authors.initials: NA
authors.lastname: Kalbani
authors.affiliation: College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), United Arab Emirates.
authors.forename: Rouda
authors.initials: R
authors.lastname: Abdulla
authors.affiliation: Ajman University of Sciences and Technology, Ajman, United Arab Emirates.
authors.forename: Sahar
authors.initials: S
authors.lastname: Asim
authors.affiliation: Hacettepe University, Sihhiye 06100, Ankara, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Erkekoglu
authors.affiliation: Tawam Hospital, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates.
authors.forename: Saif Al
authors.initials: SA
authors.lastname: Nuaimi
authors.affiliation: Al-Ain Hospital, Abu Dhabi Health Services Company (SEHA), Al-Ain, United Arab Emirates.
authors.forename: Aaesha Al
authors.initials: AA
authors.lastname: Suwaidi
keywords: Adherence; Cardiovascular diseases; Cardiovascular medications; Non-adherence