AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2578-8949/179
1Associate Professor of Dermatology, department of internal medicine, medical college, University of Umm Al QuraMakkah.
2General practitioner, Administration of primary health care sector, asser health cluster, MOH, abha, Saudi Arabia.
3General Practitioner, King Abdulaziz Hospital, Makkah - Saudi Arabia.
4Family medical resident, Department of family and community medicine, king abdulaziz medical city, MNGHA, Jeddah, Saudi Arabia.
5Anesthesia resident, Department of anesthesiology, King Abdullah Medical City,Makkah, Saudi Arabia.
*Corresponding Author: Hassan Ali AlZubeidi, Family medical resident, Department of family and community medicine, king abdulaziz medical city, MNGHA, Jeddah, Saudi Arabia.
Citation: Ahmed Z. Allayali, Abdulrhman M. Alqarni, Reem Brashi, Hassan A. AlZubeidi, Jawharah M. Tirkistani, (2025), Barriers to Care-Seeking and Treatment Adherence Among Dermatology Patients in Makkah Saudi Arabia, Dermatology and Dermatitis, 12(1); DOI:10.31579/2578-8949/179
Copyright: © 2025, Hassan Ali AlZubeidi. This is an open-access article distributed under the terms of The Creative Commons. Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 23 November 2024 | Accepted: 08 January 2025 | Published: 16 January 2025
Keywords: dermatology; patients; adherence; medications; medical care; commitment; saudi arabia
Background: Barrier documentation and dermatology access are the primary steps to discourse the dermatological needs of the underserved population. Access to healthcare and following prescribed treatments can be challenging due to various factors, including socioeconomic status, cultural differences, health systems, and transportation issues.
Aim: This study aims to assess barriers to care-seeking and treatment adherence among dermatology patients in Makkah Saudi Arabia.
Methods and materials: A descriptive cross-sectional web-based study was conducted. Adults aged 18 years and above, living in Makkah Saudi Arabia who have visited a dermatology clinic before or have a chronic dermatological condition and who agree to participate in the study were included. The data were collected through a pretested, structured online questionnaire. The survey is divided into 3 sections covering socio-demographic data, barriers to care-seeking, and treatment adherence. The study survey was uploaded online using social media platforms, the data was extracted into a Microsoft Excel Spreadsheet and analyzed by SPSS data package version 21.
Results: A total of 270 eligible dermatology patient completed the study questionnaire. Patients' ages ranged from 18 to 91 years with a mean age of 28.1 ± 10.5 years old. A total of 193 (71.5%) of the patients avoided visiting a dermatologist because of a skin or hair problem, and 165 (61.1%) had difficulties finding a dermatologist or skin care specialist. Also, 224 (83%) had difficulty adhering to the treatment plan prescribed for their skin condition mainly due to taking a long time to apply treatments (37.1%), high medication cost (22.6%), and the treatment composition being unacceptable (15.4%).
Conclusion: In conclusion, the current study revealed that there was poor adherence of the dermatological patients for medical care mainly due to financial issues and difficulty in finding a dermatologist or having an appointment. Also. Patient commitment to the prescribed treatment or treatment plan was poor mainly due to drug cost or delayed response to treatment.
Skin diseases are a major health issue that affects many people worldwide, and it can have a significant impact on their quality of life [1, 2]. The World Health Organization (WHO) states that skin disease prevalence varies from 20% to 70% in different regions of the world.
[3]. Skin conditions are diverse, and they can range from acne, eczema, psoriasis, skin cancer, and many other acute and chronic conditions [4]. While most of these conditions have effective treatments, many patients face multiple challenges when it comes to accessing dermatological health care services. Several barriers can affect the ability of treatment companies to deliver care effectively [5, 6].
The terms "adherence" and "compliance" are used to describe how well a person follows the healthcare provider's recommendations. "Adherence" is preferred as it portrays patients as active decision-makers in their medical care. In contrast, "compliance" suggests that patients are passive receivers of instructions from healthcare providers [7, 8].
Access to healthcare and following prescribed treatments can be challenging due to various factors, including socioeconomic status, cultural differences, health systems, and transportation issues [9, 10]. treatment adherence can also be impacted by side effects, forgetfulness, and a lack of motivation. These barriers are complex and multifactorial, and they can significantly affect an individual's ability to seek care and follow through with treatment [11].
People who suffer from skin diseases often experience a decrease in their quality of life [12]. However, they cannot always be trusted to take the prescribed medication as directed.
The adherence rate is generally low for systemic treatments, and even worse for topical
treatments, as they can be messier and more time-consuming to apply. The current study aimed to assess dermatology patients' barriers to care-seeking and treatment adherence in Makkah Saudi Arabia.
A descriptive cross-sectional web-based study was conducted to assess dermatology patients' adherence and barriers to seeking medical care and treatment. Adults aged 18 years and above, living in Makkah Saudi Arabia who have visited a dermatology clinic before or have a chronic dermatological condition and who agree to participate in the study were included. Children under 18 years old, who haven’t visited a dermatology clinic before or don’t have a chronic dermatological condition, and Those who refused to participate in the study were excluded. The sample size was calculated using Daniel's sample size formula will be 385 participants, a margin of error equals 5%, and a confidence level of 95%. The duration of the data collection is around 3 months, and the study period overall is 12 months. The data were collected through a pretested, structured online questionnaire preceded by consent and ensured to maintain the confidentiality of the data. The questionnaire was developed by the study researchers from the literature and expert opinions and was translated into the Arabic language. The validity of the questionnaire was tested through a pilot study. The validated questionnaire included 28 items to assess the barriers to care-seeking and treatment adherence among dermatology patients in Makkah Saudi Arabia. The survey is divided into 3 sections, the first section for informed consent from the participants, the second part includes socio-demographic data (age, gender, educational level, and marital status), and the third part includes items assessing the barriers to care-seeking and treatment adherence (20 items). The data were gathered from trained data collectors from all over the Makkah Region in Saudi Kingdom, was distribute the survey through social media platforms, such as Facebook, Twitter, Instagram, and WhatsApp. Then, the data was extracted into a Microsoft Excel Spreadsheet.
Data analysis
The data were collected, reviewed, and then fed to Statistical Package for Social Sciences version 21 (SPSS: An IBM Company). All statistical methods used were two-tailed with an alpha level of 0.05 considering significance if P value less than or equal to 0.05. Descriptive analysis was done by prescribing frequency distribution and percentage for study variables including dermatology patients' data, having health insurance, difficulties and barriers to care-seeking, and barriers to treatment adherence. Also, dermatology patient's knowledge and awareness of skin diseases were tabulated. Satisfaction of dermatology patients about provided care and dermatology patients' suggestions for improving care-seeking and treatment adherence were graphed. Cross tabulation for showing factors associated with dermatology patients' treatment adherence was carried out with Pearson chi-square test for significance and exact probability test if there were small frequency distributions.
Socio-demographic
A total of 270 eligible dermatology patients completed the study questionnaire. Patients ages ranged from 18 to 91 years with a mean age of 28.1 ± 10.5 years old. A total of 182 (67.4%) patients were females and most of them (92.2%) were Saudi. As for educational level, 187 (69.3%) had bachelor degree, 50 (18.5%) had secondary educational level and 25 (9.3%) had post-graduate degree. A total of 143 (53%) were students, and 90 (33.3%) were employee. Monthly income less than 5000 SR was reported among 141 (52.2%) patents and 57 (21.1%) had monthly income 5000-10000 SR and only 30 (11.1%) had monthly income exceeding 15000 SR. A total of 98 (36.3%) had medical insurance (Table1).
| Personal data | No | % |
| Age in years | ||
| < 20 | 50 | 18.5% |
| 21-29 | 135 | 50.0% |
| 30-39 | 46 | 17.0% |
| 40+ | 39 | 14.4% |
| Gender | ||
| Male | 88 | 32.6% |
| Female | 182 | 67.4% |
| Nationality | ||
| Saudi | 249 | 92.2% |
| Non-Saudi | 21 | 7.8% |
| Educational level | ||
| Below secondary | 8 | 3.0% |
| Secondary | 50 | 18.5% |
| Bachelor degree | 187 | 69.3% |
| Post-graduate degree | 25 | 9.3% |
| Work | ||
| Not working / retired | 37 | 13.7% |
| Student | 143 | 53.0% |
| Employee | 90 | 33.3% |
| Monthlyincome | ||
| < 5000 SR | 141 | 52.2% |
| 5000-10000 SR | 57 | 21.1% |
| 10000-15000 SR | 42 | 15.6% |
| > 15000SR | 30 | 11.1% |
| Do you have insurance | ||
| Yes | 98 | 36.3% |
| No | 172 | 63.7% |
Table 1: Personal characteristics of dermatology patients in Makkah Saudi Arabia
Barriers affected patient accessibility to dermatological services and adherence to treatment plan.
Table 2. Difficulties and barriers to care-seeking among dermatology patients in Makkah Saudi. A total of 193 (71.5%) of the patients avoided visiting a dermatologist because of a skin or hair problem, 165 (61.1%) had difficulties finding a dermatologist or skin care specialist, 130 (48.1%) had difficulties making an appointment with a dermatologist or skin care specialist, and 124 (45.9%) encountered difficulties accessing dermatology services due to location or transportation.
| Difficulties | Count | Column N % |
| Have you ever avoided visiting a dermatologist because of a skinor hair problem? | ||
| Yes | 3 | 71.5% |
| No | 77 | 28.5% |
| Have you had any difficulties finding a dermatologist or skin care specialist? | ||
| Yes | 5 | 61.1% |
| No | 5 | 38.9% |
| Have you had difficulties making an appointment with a dermatologist or skin care specialist? | ||
| Yes | 0 | 48.1% |
| No | 0 | 51.9% |
| Have you encountered any difficulties accessing dermatology services due to location or transportation? | ||
| Yes | 4 | 45.9% |
| No | 6 | 54.1% |
Table 2: Difficulties and barriers to care-seeking among dermatology patients in Makkah Saudi
Table 3. Barriers to Treatment adherence among dermatology patients in Makkah Saudi Arabia. As for the reason for non-seeking for having medications for skin conditions, the most reported were financial challenges and/or health insurance issues (27.1%), Challenges with health services (26%), use of alternative therapy (folk medicine) (17.2%), and lack of symptoms (13%). A total of 193 (71.5%) faced difficulties in obtaining medications prescribed by your dermatologist, where the most reported included the high cost of the treatment (70.2%), lack of treatment in pharmacies (49.2%), treatment requiring frequent refilling or replenishment (35.6%), and treatment is not available in their area (28.3%). Also, 224 (83%) had difficulty adhering to the treatment plan prescribed for their skin condition mainly due to taking a long time to apply treatments (37.1%), high medication cost (22.6%), the treatment composition being unacceptable (15.4%), Unpleasant Side effects (11.8%), and Complicated treatment plan (11.8%). Exact of 156 (57.8%) modified their prescribed treatment plan for a skin condition without consulting a dermatologist mainly due to Delayed improvement (59.6%), desire to try another treatment plan (47.4%), and side effects (29.5%).
| Medications adherence | No | % |
| What is the reason for non-seeking forhaving medications forskin conditions? | ||
| Financial challenges and/or health insurance issues | 52 | 27.1% |
| Challenges with health services | 50 | 26.0% |
| Use of alternative therapy(folk medicine) | 33 | 17.2% |
| My healthcondition is good and I have no symptoms | 25 | 13.0% |
| Lack of trust in the doctor | 21 | 10.9% |
| Cultural challenges | 6 | 3.1% |
| Others | 5 | 2.6% |
| Have you facedany difficulties in obtaining medications prescribed by your dermatologist? | ||
| Yes | 193 | 71.5% |
| No | 77 | 28.5% |
| If yes, mentionthese difficulties | ||
| The costof treatment was very high | 134 | 70.2% |
| It was difficult to find treatment in pharmacies | 94 | 49.2% |
| Treatment requires frequent refilling or replenishment | 68 | 35.6% |
| The treatment is not available in my area | 54 | 28.3% |
| Others | 2 | 1.0% |
| Have you haddifficulty adhering to the treatment plan prescribed for your skin condition? | ||
| Yes | 224 | 83.0% |
| No | 46 | 17.0% |
| What is the reason for non-compliance withthe prescribed treatment or medication? | ||
| Takes longtime to applytreatments | 82 | 37.1% |
| High medication cost | 50 | 22.6% |
| The treatment composition is unacceptable | 34 | 15.4% |
| Unpleasant Side effects | 26 | 11.8% |
| Complicated treatment plan | 26 | 11.8% |
| Takes longtime to treat | 3 | 1.4% |
| Have you modified your prescribed treatment plan for a skin condition without consulting a dermatologist? | ||
| Yes | 156 | 57.8% |
| No | 114 | 42.2% |
| If yes, why you modified | ||
| Delayed improvement | 93 | 59.6% |
| Desire to try anothertreatment plan | 74 | 47.4% |
| Medications sideeffects | 46 | 29.5% |
Table 3: Barriers to Treatment adherence among dermatology patients in Makkah Saudi Arabia
Participants overall satisfaction with the provided dermatological care.
Figure 1. Satisfaction of dermatology patients about provided care and dermatologists' role. Exact of 187 (69.3%) of the patients think
dermatologists and skin care specialists are adequately trained to treat skin conditions. On the other hand, 152 (56.3%) felt dissatisfied with the information given to them by their dermatologist and 30 (11.1%) were unable to understand the diagnosis provided by a dermatologist.
Figure 1: Satisfaction of dermatology patients about provided care and dermatologists role
Figure 2. Dermatology patients' suggestions for improving care-seeking and treatment adherence. The most reported suggestions were Providing medical centers specialized in dermatology in different regions of the Kingdom (66%), Providing remote consultation services for skin disease patients in the Kingdom (57%), Increasing the numbers of dermatologists
in the Kingdom (55%), and Providing awareness and educational programs to the public about skin diseases (47%).
Providing medical centers specialized in dermatology in different regions of the 66% Kingdom
Figure 2: Dermatology patients' suggestions for improving care-seeking and treatment adherence
Table 4. Dermatology patient's knowledge and awareness of skin diseases, Makkah, Saudi Arabia. A total of 133 (49.2%) of the patients reported having good to excellent knowledge about skin diseases. The most reported sources of information included social media and the internet (43%), dermatologists (21.9%), and Personal experience (20%).
| Knowledge | No | % |
| How would you rate your general knowledge of skin diseases? | ||
| Very poor | 6 | 2.2% |
| Poor | 40 | 14.8% |
| Intermediate | 91 | 33.7% |
| Good | 80 | 29.6% |
| Excellent | 53 | 19.6% |
| Source of information about skin diseases | ||
| Social media/ internet | 116 | 43.0% |
| Dermatologists | 59 | 21.9% |
| Personal experience | 54 | 20.0% |
| Family / friends | 41 | 15.2% |
Table 4: Dermatology patient's knowledge and awareness of skin diseases, Makkah, Saudi Arabia
Factors | Have you had difficulty adhering to the treatment plan prescribed for your skin condition? |
p-value | |||
| Yes | No | ||||
| No | % | No | % | ||
| Age in years | |||||
| < 20 | 41 | 82.0% | 9 | 18.0% | |
| 21-29 | 119 | 88.1% | 16 | 11.9% | .099 |
| 30-39 | 34 | 73.9% | 12 | 26.1% | |
| 40+ | 30 | 76.9% | 9 | 23.1% | |
| Gender | |||||
| Male | 77 | 87.5% | 11 | 12.5% | .186 |
| Female | 147 | 80.8% | 35 | 19.2% | |
| Nationality | |||||
| Saudi | 206 | 82.7% | 43 | 17.3% | .727 |
| Non-Saudi | 18 | 85.7% | 3 | 14.3% | |
| Educational level | |||||
| Below secondary | 3 | 37.5% | 5 | 62.5% | |
| Secondary | 42 | 84.0% | 8 | 16.0% | .001* |
| Bachelor degree | 163 | 87.2% | 24 | 12.8% | |
| Post-graduate degree | 16 | 64.0% | 9 | 36.0% | |
| Work | |||||
| Not working/retired | 24 | 64.9% | 13 | 35.1% | .006* |
| Student | 121 | 84.6% | 22 | 15.4% | |
| Employee | 79 | 87.8% | 11 | 12.2% | |
| Do you haveinsurance? | |||||
| Yes | 83 | 84.7% | 15 | 15.3% | .568 |
| No | 141 | 82.0% | 31 | 18.0% | |
| Have you facedany difficulties in obtaining medications prescribed by your dermatologist? |
.001* | ||||
| Yes | 170 | 88.1% | 23 | 11.9% | |
| No | 54 | 70.1% | 23 | 29.9% | |
| Have you modified your prescribed treatment plan for a skin condition without consulting a dermatologist? |
.013* | ||||
| Yes | 137 | 87.8% | 19 | 12.2% | |
| No | 87 | 76.3% | 27 | 23.7% | |
| How would you rate yourgeneral knowledge of skin diseases? | |||||
| Very poor | 3 | 50.0% | 3 | 50.0% | |
| Poor | 36 | 90.0% | 4 | 10.0% | .002*^ |
| Intermediate | 79 | 86.8% | 12 | 13.2% | |
| Good | 70 | 87.5% | 10 | 12.5% | |
| Excellent | 36 | 67.9% | 17 | 32.1% | |
| Source of information about skin diseases | |||||
| Dermatologists | 52 | 88.1% | 7 | 11.9% | |
| Social media/ internet | 104 | 89.7% | 12 | 10.3% | .001*^ |
| Family / friends | 32 | 78.0% | 9 | 22.0% | |
| Personal experience | 36 | 66.7% | 18 | 33.3% | |
Table 5: Factors associated with dermatology patients' treatment adherence Table 4. Dermatology patient's knowledge and awareness of skin diseases, Makkah, Saudi Arabia
Non-adherence to medication is linked with poor medical conditions, higher occurrence of comorbidities, increased costs, and higher mortality rates [13]. The World Health Organization estimated that in 2003, the average adherence rate among patients with chronic diseases in developed countries was 50%, and even lower in developing countries. From 2005 to 2007, nearly 500,000 emergency department visits were related to
medication non-adherence [14,15]. Nationally, the cost of hospital admissions due to medication non-adherence approaches nearly 100 billion US dollars per year [16].
The current study aimed to assess barriers to care-seeking and treatment adherence among dermatology patients in Makkah Saudi Arabia. Regarding medical care, the study revealed that most of the patients avoided visiting a dermatologist because of a skin or hair problem which is similar to Venkatesh K et al. [17], where 51.8% of participants avoided or delayed dermatology care. Also, nearly two-thirds of them had
difficulties finding a dermatologist or skin care specialist, and nearly half of the patients had difficulties making an appointment with a dermatologist or a skin care specialist. Likewise, less than half of them encountered difficulties accessing dermatology services due to location or transportation. Taber JM et al. [18], identified three main categories of reasons for people avoiding medical care. Firstly, over one-third of the participants (33.3%) felt negatively about seeking medical care, for reasons related to physicians, healthcare organizations, or affective concerns. Secondly, a subset of participants (12.2%) reported a low perceived need to seek medical care, often because they believed their illness or symptoms would improve over time (4.0%). Thirdly, many participants (58.4%) reported traditional barriers to medical care, such as high costs (24.1%), no health insurance (8.3%), and time constraints (15.6%).
Based on these results, we developed a conceptual model of medical care avoidance. Other studies revealed that traditional barriers limiting access to or ease of seeking medical care included lack of health insurance and time constraints [19-25]. According to many reports, some people have expressed negative experiences when seeking medical care. These experiences include problems with communication and concerns about the trustworthiness and expertise of physicians. This is in line with previous research that highlights the importance of a good patient-physician relationship and medical trust in maintaining medication adherence, healthcare utilization, and positive health outcomes [26-29]. In the dermatology field, Duniphin DD [30], showed that the three most significant barriers to accessing healthcare were being uninsured (36.4%), living in an area with a shortage of medical resources (22.0%), and living below the federal poverty level (33.0%). The use of teledermatology was supported by 90.90% of participants as an additional way to receive healthcare, with 81.8% saying it would improve access to care. The convenience of the service was also highlighted as a benefit by 72.7% of respondents. According to Cyr ME et al. [31], limited access to dermatology specialists is caused by rural residence and socioeconomic barriers in underserved populations.
Concerning treatment adherence, the vast majority of the study participants had difficulty adhering to the treatment plan prescribed for their skin condition. The most reported reasons included taking a long time to apply treatments, high medication costs, the treatment composition being unacceptable, and unpleasant Side effects. Also, it was clear that most of the patients faced difficulties in obtaining medications prescribed by their dermatologist, where the most reported included the high cost of the treatment, lack of treatment in pharmacies, treatment requiring frequent refilling or replenishment, and treatment not available in their area. More than half of the current study patients modified their prescribed treatment plan for a skin condition without consulting a dermatologist mainly due to delayed improvement, their desire to try another treatment plan, and side effects. In a study by Venkatesh K et al. [17], it was found that 22.7% of patients did not follow their dermatologist's treatment recommendations which is much lower than reported in the current study. The reasons for nonadherence included side effects and adverse events, high treatment cost, complexity of the treatment plan and forgetfulness, disagreement, or distrust with the healthcare provider (13.2%), and perceived lack of medication efficacy. Two studies conducted at dermatology clinics looked at newly prescribed medications and found that only 82% and 65% of patients, respectively, filled their prescriptions [31,32]. In terms of adherence to topical agents for actinic keratoses, one study with 305 patients found a rate of 37%, whereas another study with 19 patients found a rate of 86%. [33,34].
As for suggestions to improve patient adherence, the most reported by the study patients included providing medical centers specialized in dermatology in different regions of the Kingdom, providing remote consultation services for skin disease patients in the Kingdom, Increasing the numbers of dermatologists in the Kingdom, and Providing awareness and educational programs to the public about skin diseases where all were reported by at least half of the respondents.
Our study faced several limitations being a cross-sectional study using an online questionnaire may affect the sample's representativeness as only those who can read and have smartphones will participate in the study. This in turn may affect the generalizability of the results. Also, most of the participants were females which may underestimate the male related satisfaction.
There are several avenues for future research. Larger nationwide studies incorporating both rural and urban areas are needed to develop a comprehensive understanding of healthcare barriers faced across different domains in the country. Qualitative research methods like interviews could provide richer insights into patients' experiences navigating the healthcare system and how it influences their behaviors. Furthermore, intervention research is required to evaluate strategies to enhance access and adherence, such as subsidizing treatment costs, establishing transportation services, utilizing telemedicine approaches, and other integrated solutions targeting multiple barriers simultaneously. Prospective research designs can help establish how barriers and facilitating factors change over the course of chronic skin conditions, and their long-term impact on health outcomes. There is also a need to explore patient and provider predictors of adherence to aid the development of tailored programs that promote shared decision making and self-management support. Overall, addressing the barriers identified through effective, evidence-based interventions can help improve health outcomes and quality of life for patients with dermatological conditions.
In conclusion, the current study revealed that there was poor adherence of the dermatological patients for medical care mainly due to financial issues and difficulty in finding a dermatologist or having an appointment. Also. Patient commitment to the prescribed treatment or treatment plan was poor mainly due to drug cost or delayed response to treatment. Additionally, more than half of the patients not only were incompliant but also modified the treatment prescribed. Periodic health education, assessing patients' preferences and modifying barriers can help in improving patient adherence.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
