Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic...

Area of Science:

• Public Health
• Cardiology
• Health Services Research

Background:

• Cardiovascular diseases (CVD) pose a significant health burden in low- and middle-income countries (LMICs).
• Medication adherence is crucial for effective CVD management, but suboptimal adherence is a major challenge.
• Interventions to improve medication adherence are vital for better health outcomes in these settings.

Purpose of the Study:

• To systematically review interventions aimed at enhancing medication adherence among individuals with CVD in LMICs.
• To critically evaluate the effectiveness of various intervention strategies.

Main Methods:

• A systematic review of studies published between 2010 and 2020 was conducted.
• Searches were performed in PubMed, Embase, and CINAHL for relevant medication adherence interventions in LMICs.
• Studies reporting adherence as an outcome and detailing adherence measurement tools were included.

Main Results:

• Forty-five articles were included, with most interventions involving counseling and education delivered by nurses, pharmacists, or community health workers.
• Technology-based reminders (e.g., SMS, phone calls) and multi-component interventions were more effective than single-strategy approaches.
• Combined patient- and provider-level interventions demonstrated a larger impact on medication adherence.

Conclusions:

• Combined interventions, including patient education, reminders, fixed-dose combinations, and team-based care, are more effective for CVD medication adherence in LMICs.
• Interventions were found to be moderately effective overall.
• Future research should focus on non-physician-led and locally adapted interventions.