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Temporal effectiveness of interventions to improve medication adherence: A network meta-analysis
Elyssa Wiecek1, Fernanda S Tonin2, Andrea Torres-Robles1
1Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Plos One
|March 13, 2019
Summary
Multicomponent interventions are most effective for long-term medication adherence. Technical and reward strategies work short-term, while educational and attitudinal approaches improve adherence over time.
Area of Science:
- Pharmacology
- Health Services Research
- Behavioral Science
Background:
- Medication adherence is crucial for managing chronic conditions, especially with an aging population.
- Existing adherence interventions show varied effectiveness, necessitating research into sustainable long-term strategies.
- A consensus on the most effective long-term medication adherence approach is lacking due to heterogeneity in study findings.
Purpose of the Study:
- To determine the comparative effectiveness of different interventions for improving medication adherence over time in adults.
- To identify which types of interventions are most effective for maintaining medication adherence in the long term.
- To provide evidence for developing sustainable strategies to enhance patient medication adherence.
Main Methods:
- A systematic review and network meta-analysis of meta-analyses evaluating medication adherence interventions.
- Inclusion of experimental studies with comparison groups assessing educational, attitudinal, technical, or reward-based interventions.
- Categorization of interventions and performance of four network meta-analyses based on patient follow-up duration (0-3, 4-6, 7-9, and ≥10 months).
Main Results:
- All reviewed interventions improved medication adherence compared to standard care.
- Technical interventions showed short-term effectiveness (4-6 months: OR 0.34), and attitudinal interventions (7-9 months: OR 0.37).
- Multicomponent interventions (educational + attitudinal + technical) were most effective for long-term adherence (≥10 months: OR 0.49).
Conclusions:
- Multicomponent interventions are essential for maintaining long-term medication adherence.
- The effectiveness of interventions varies by type and duration, with educational and attitudinal components showing delayed but sustained benefits.
- Future research should prioritize cost-effective, integrated approaches for routine clinical practice to ensure medication adherence.
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