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Medication adherence interventions that target subjects with adherence problems: Systematic review and meta-analysis
Vicki S Conn1, Todd M Ruppar1, Maithe Enriquez1
1Sinclair School of Nursing, University of Missouri, Columbia, MO 65211, USA.
Research in Social & Administrative Pharmacy : RSAP
|July 13, 2015
Summary
Interventions to improve medication adherence in adults with adherence difficulties show modest but significant effects. Behavioral strategies like prompts and habit-linking are effective, especially with face-to-face support.
Area of Science:
- Health outcomes research
- Behavioral science
- Clinical intervention effectiveness
Background:
- Inadequate medication adherence is a significant, often overlooked, contributor to poor health outcomes.
- Numerous intervention trials have aimed to improve medication adherence, primarily in adults.
- This review synthesizes the effectiveness of interventions specifically for individuals with existing medication adherence challenges.
Purpose of the Study:
- To systematically review and meta-analyze studies on medication adherence interventions.
- To evaluate the effectiveness of interventions for adults with documented difficulties in adhering to medications.
Main Methods:
- Systematic review and meta-analysis of primary research studies.
- Inclusion criteria: interventions to increase medication adherence in adults with adherence difficulties, reporting behavioral outcomes.
- Data extraction included participant demographics, intervention characteristics, and methodological features; effect sizes calculated as standardized mean differences.
Main Results:
- Analysis of 53 reports involving 8243 participants.
- Overall effect size for treatment vs. control was 0.301; pre- vs. post-intervention was 0.533.
- Interventions with prompts (0.497) and habit-linking (0.574) showed larger effect sizes. Pill counts and electronic monitoring yielded largest effects.
Conclusions:
- Interventions for individuals with medication adherence problems yield modest but significant improvements in behavior.
- Behavioral strategies, including prompts and linking medication to habits, are supported.
- Face-to-face interventions are crucial for patients with a history of adherence issues.
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