Interventions for enhancing medication adherence

Haynes, R. Brian; Yao, Xiaomei; Degani, Antonella; Kripalani, Sunil; Garg, Amit X.; McDonald, Helen

doi:10.1002/14651858.cd000011.pub2

Cited by 999 publications

(1,349 citation statements)

References 295 publications

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“…This finding is consistent with a review 29 of interventions to promote adherence with medication use, which concluded that complex interventions, including several components, were most likely to be successful. Thus, this study was not designed to distinguish the separate effects of SMS reminders and free medication on follow-up because we did not think that either intervention alone would be as effective and both interventions were inexpensive, meaning there was little practical disadvantage to aggregating them.…”

Section: Discussionsupporting

confidence: 89%

Interventions to Promote Follow-up After Trabeculectomy Surgery in Rural Southern China

Jin

et al. 2016

JAMA Ophthalmol

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Section: Discussionsupporting

confidence: 89%

Interventions to Promote Follow-up After Trabeculectomy Surgery in Rural Southern China

Jin

et al. 2016

JAMA Ophthalmol

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“…Self-monitoring (recording exercise behaviour) is often suggested as a way to improve chronic illness selfmanagement behaviours [30][31][32][33]. The presence of exercise self-monitoring was associated with lower ESs in this metaanalysis.…”

Section: Discussionmentioning

confidence: 62%

Metabolic effects of interventions to increase exercise in adults with type 2 diabetes

et al. 2007

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Aims/hypothesis The aim of this meta-analysis was to integrate the results of primary research testing the effect of diabetes self-management interventions that included recommendations to increase exercise on metabolic outcomes among adults with type 2 diabetes. Materials and methods Extensive literature searching strategies were used to identify published and unpublished intervention studies that measured glycated haemoglobin outcomes. Primary study results were coded. Fixed-and random-effects meta-analytic procedures included moderator analyses.Results Data were synthesised across 10,455 subjects from 103 research reports. The overall mean weighted effect size for two-group comparisons was 0.29 (higher mean for treatment than control). This effect size is consistent with a difference in HbA 1c means of 0.45% (e.g. 7.38% for treatment subjects vs 7.83% for control subjects). For single-group studies, the overall mean weighted effect size was 0.32-0.34. Control group subjects experienced no improvement in metabolic control during participation in the studies. Interventions that targeted multiple health behaviours resulted in smaller effect size estimates (0.22) than interventions that focused only on exercise behaviours (0.45). Funded studies reported greater improvements in metabolic controls. Studies with a greater proportion of female subjects reported lower effect sizes. Baseline HbA 1c and BMI were unrelated to metabolic outcomes. Conclusions/interpretation These findings suggest that self-management interventions that include exercise recommendations improve metabolic control, despite considerable heterogeneity in the magnitude of the intervention effect. Interventions that emphasise exercise may be especially effective in improving metabolic control. Primary research testing interventions in randomised trials to confirm causal relationships would be constructive.Keywords Diabetes mellitus, type 2 . Exercise . Haemoglobin A, glycosylated . HbA 1c . Meta-analysis Abbreviations CLES common language effect size ES effect size GhB glycated haemoglobin Diabetologia (2007) 50:913-921

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“…13,14,6 The improvement of medication adherence is a global priority, 15 yet only a few experimental interventions have been proven to be successful. 16 These include interventions that reduce out-of-pocket costs, simplify regimens, facilitate delivery of medications, or offer behavioral support. [16][17][18][19] Unfortunately, many of these approaches have been difficult to sustain outside of research settings.…”

Section: Introductionmentioning

confidence: 99%

“…16 These include interventions that reduce out-of-pocket costs, simplify regimens, facilitate delivery of medications, or offer behavioral support. [16][17][18][19] Unfortunately, many of these approaches have been difficult to sustain outside of research settings. 16 To test potentially sustainable interventions in real world settings, we conducted a randomized controlled clinical trial (RCT) testing the comparative effectiveness of a telephone-based behavioral intervention versus an educational DVD at improving 12-month adherence to thienopiridines among minority coronary stent recipients.…”

mentioning

confidence: 99%

Can Phone-Based Motivational Interviewing Improve Medication Adherence to Antiplatelet Medications After a Coronary Stent Among Racial Minorities? A Randomized Trial

et al. 2014

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BACKGROUND:Minorities have lower adherence to cardiovascular medications and have worst cardiovascular outcomes post coronary stent placement OBJECTIVE: The aim of this study is to compare the efficacy of phone-delivered Motivational Interviewing (MINT) to an educational video at improving adherence to antiplatelet medications among insured minorities. DESIGN: This was a randomized study. PARTICIPANTS: We identified minorities with a recently placed coronary stent from an administrative data set by using a previously validated algorithm. INTERVENTIONS: MINT subjects received quarterly phone calls and the DVD group received a one-time mailed video. MAIN MEASURES: Outcome variables were collected at baseline and at 12-month post-stent, using surveys and administrative data. The primary outcome was antiplatelet (clopidogrel and prasugrel) adherence measured by Medication Possession Ratio (MPR) and self-reported adherence (Morisky score). We also measured appropriate adherence defined as an MPR ≥ 0.80. KEY RESULTS: We recruited 452 minority subjects with a new coronary stent (44 % Hispanics and 56 % Black). The patients had a mean age of 69.5±8.8, 58 % were males, 78 % had an income lower than $30,000 per year and only 22 % had achieved high school education or higher. The MPR for antiplatelet medications was 0.77 for the MINT group compared to 0.70 for the DVD group (p<0.05). The percentage of subjects with adequate adherence to their antiplatelet medication was 64 % in the MINT group and 50 % in the DVD group (p<0.01). Self-reported adherence at 12 months was higher in the MINT group compared to the DVD group (p<0.01). Results were similar among drug-eluting stent (DES) recipients. CONCLUSIONS: Among racial minorities, a phone-based motivational interview is effective at improving adherence to antiplatelet medications post coronary stent placement. Phone-based MINT seems to be a promising and cost-effective strategy to modify risk behaviors among minority populations at high cardiovascular risk. BACKGROUNDThe safe use of coronary stents requires the daily use of thienopyridines for 3 to 12 months after percutaneous coronary intervention (PCI). 1 The premature discontinuation of these medications 1 is associated with an increased risk of instent thrombosis, cardiovascular events and death. 2-6 Unfortunately, lack of medication adherence is common and is associated with significant health care costs and mortality. 7,8 Vulnerable groups such as racial minorities and the elderly have a higher risk of poor adherence. 5,6,9,10 In the case of antiplateletet medications, blacks are more likely to not receive a clopidogrel prescription 11 or to not fill it after PCI. Further, our prior analyses of insurer claims data showed that minority populations were less adherent to antiplatelet medications post drug-eluting stent (DES) placement. 12 The lack of appropriate use of evidence-based therapies after PCI may partially contribute to the excess morbidity and mortality reported among minorities. 13,14,6 The improvement of med...

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Interventions for enhancing medication adherence

Cited by 999 publications

References 295 publications

Interventions to Promote Follow-up After Trabeculectomy Surgery in Rural Southern China

Interventions to Promote Follow-up After Trabeculectomy Surgery in Rural Southern China

Metabolic effects of interventions to increase exercise in adults with type 2 diabetes

Can Phone-Based Motivational Interviewing Improve Medication Adherence to Antiplatelet Medications After a Coronary Stent Among Racial Minorities? A Randomized Trial

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