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Medication adherence interventions and outcomes: an overview of systematic reviews
  1. Nina C Wilhelmsen1,
  2. Tommy Eriksson1,2
  1. 1 Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  2. 2 Department of Biomedical Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden
  1. Correspondence to Dr Tommy Eriksson, Clinical Pharmacology, Laboratory Medicine, Lund University, Lund 221 00, Sweden; tommy.eriksson{at}mah.se

Abstract

Objective To present evidence for healthcare-provided medication adherence interventions on clinical, economic and humanistic outcomes among patients.

Methods Literature search of systematic reviews in Medline, Embase and CINAHL (2007–2017), validation of quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses questionnaires and, finally, extraction, combination and tabulation of results for included studies.

Results From eight systematic reviews with medium to high AMSTAR 2 score, 37 randomised controlled studies involving 28 600 participants were extracted. Patient education and counselling showed some positive effects on medication adherence. Patient education also showed some positive effects on morbidity, healthcare utilities and patient satisfaction. Counselling had some benefit on mortality and healthcare utilisation. Simplifying doses was shown to have some benefit on morbidity and patient satisfaction. Interventions delivered by pharmacists and nurses showed a better result in improving adherence and outcomes than interventions delivered by general practitioners.

Conclusions Some interventions were found to have positive effect on adherence and outcomes, but no single strategy showed improvement in all settings. For future research patients should be screened for non-adherence to reveal both if they are non-adherent and type of non-adherence, as well as bigger sample sizes and longer duration of follow-up.

  • adherence
  • review
  • outcomes
  • intervention
  • medication

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