Interventional tools to improve medication adherence: review of literature

Abstract

Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons.

High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study

“…Most interventions associated with adherence improvements are not associated with improvements in other outcomes; indeed, in the last few decades, the degree of nonadherence has remained unchanged 19. In an older meta-analyis by Roter et al,25 no single strategy or programmatic focus showed any clear advantage compared with any other, and comprehensive interventions combining cognitive, behavioral, and affective components were more effective than single-focus interventions.…”

The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy

“…The fact that less than half of the participants used the pill organizer, limited our ability to assess the impact of this simple intervention. Previous studies have shown that reminder packaging has a positive impact on medication adherence 34. We also used a self-reported adherence measure.…”

Effect of Medication Related Educational Interventions on Improving Medication Adherence in Patients With Type 2 Diabetes Mellitus

“…Teach-back method is an efficient patient counseling method which not only provides counseling to the patient but also assesses patients' understanding of provided information [11]. It involves initially providing all necessary information regarding drug to the patient, including indication, side effects, precautions, and frequency of the drug, after providing this information, the patient will be asked openended questions such as "when to take this drug," "for what this drug is given," "how to take the drug," "what should you avoid while taking the drug," and "how often you should take the medicine."…”