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Consultation-based interventions to optimize medication adherence in primary care: a systematic review.
Caitriona Callan1, Jadine Scragg1, Richard Stevens1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Family Practice
|March 3, 2026
Summary
Consultation interventions may slightly boost medication adherence for type 2 diabetes and respiratory conditions. However, robust evidence for clinical benefits or effectiveness in other diseases is lacking, highlighting the need for feasible interventions.
Area of Science:
- Clinical Pharmacy
- Evidence-Based Medicine
- Public Health
Background:
- Medication adherence is crucial for managing chronic diseases and preventing complications.
- Consultation-based interventions are a feasible approach in primary care settings.
- Evidence on the effectiveness of these interventions for preventative medications needs synthesis.
Purpose of the Study:
- To synthesize evidence on consultation-based interventions for medication adherence and clinical outcomes.
- To assess the feasibility of these interventions in primary care.
Main Methods:
- Systematic review and meta-analysis of randomized trials (2015 onwards).
- Included adults prescribed preventative medications for cardiovascular disease, type 2 diabetes mellitus (T2DM), chronic respiratory disease, or osteoporosis.
- Assessed adherence and clinical outcomes; meta-analyses used inverse variance heterogeneity methods.
Main Results:
- 41 studies (n=26,114) included. Modest adherence improvements for T2DM and chronic respiratory disease, but not robust to sensitivity analyses.
- No significant adherence effects for cardiovascular prevention or osteoporosis.
- No significant improvements in clinical outcomes (e.g., blood pressure, HbA1c) or hospitalizations were observed. High heterogeneity and risk of bias were noted.
Conclusions:
- Consultation-based interventions show potential for modest adherence improvements in T2DM and chronic respiratory disease.
- Robust evidence for clinical benefit or effectiveness in other conditions is currently lacking.
- Intervention feasibility is key for future research and clinical translation.
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