Interventions to Improve Medication Adherence: A Review.

Area of Science:

• Pharmacology and Health Services Research
• Clinical Interventions and Patient Outcomes
• Public Health and Chronic Disease Management

Background:

• Medication nonadherence is prevalent among adults with chronic illnesses, leading to significant mortality, hospitalizations, and healthcare costs.
• Objective methods like electronic drug monitors and pharmacy claims data are more accurate than self-report for assessing medication adherence.
• A systematic review identified 49 randomized clinical trials evaluating interventions to improve medication adherence in adults.

Discussion:

• Six categories of interventions show promise: patient education, medication regimen management, clinical pharmacist consultation, cognitive behavioral therapies, medication-taking reminders, and incentives.
• Successful interventions often involve personalized support, simplified medication regimens (e.g., combination pills), and proactive monitoring.
• The choice of intervention should consider the feasibility and resources available within a healthcare setting.

Key Insights:

• Combination pills to reduce daily pill burden can improve adherence by up to 10%.
• Clinical pharmacist co-management for chronic diseases can enhance adherence by 15%.
• Medication-taking reminders, such as telephone calls, show the highest observed improvement in adherence at 33%.

Outlook:

• Integrating effective adherence strategies into routine clinical care is feasible.
• More intensive interventions, while successful, necessitate additional investment from healthcare systems.
• Future research should focus on cost-effective and scalable interventions to address medication nonadherence.