scholarly journals Healthcare provider targeted interventions to improve medication adherence: systematic review and meta-analysis

2015 ◽  
Vol 69 (8) ◽  
pp. 889-899 ◽  
Author(s):  
V. S. Conn ◽  
T. M. Ruppar ◽  
M. Enriquez ◽  
P. S. Cooper ◽  
K. C. Chan
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Healthcare Provider ◽  
Meta Analysis ◽  
Improve Medication Adherence ◽  
Targeted Interventions

scholarly journals Interventions to Improve Medication Adherence in Patients with Schizophrenia or Bipolar Disorders: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (19) ◽  
pp. 10213
Author(s):  
Elke Loots ◽  
Eva Goossens ◽  
Toke Vanwesemael ◽  
Manuel Morrens ◽  
Bart Van Rompaey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Selection Criteria ◽  
Meta Analysis ◽  
Bipolar Disorders ◽  
Daily Practice ◽  
Improve Medication Adherence ◽  
Different Types ◽  
Family Based

Adherence to prescribed medication regimes improves outcomes for patients with severe mental illness such as schizophrenia or bipolar disorders. The aim of this systematic review and meta-analysis was to compare the effectiveness among interventions to improve medication adherence in patients with schizophrenia or bipolar disorders. Literature published in the last decade was searched for interventions studies to improve adherence in patients with schizophrenia or a bipolar disorder. Interventions were categorised on the basis of type, and the context and effectiveness of the interventions were described. Two review authors independently extracted and assessed data, following criteria outlined by the Cochrane Handbook for Systematic Reviews of Interventions. The GRADEPro (McMaster University, 2020, Ontario, Canada) was used for assessing the quality of the evidence. Twenty-three publications met the selection criteria. Different types of interventions aiming to improve adherence were tested: educational, behavioural, family-based, technological, or a combination of previous types. Meta-analysis could be performed for 10 interventions. When considered separately by subgroups on the basis of intervention type, no significant differences were found in adherence among interventions (p = 0.29; I2 = 19.9%). This review concluded that successful interventions used a combination of behavioural and educational approaches that seem easy to implement in daily practice.

scholarly journals Adherence to antihypertensive medications and associated factors among hypertensive patients in Ethiopia: Systematic review and meta-analysis

2020 ◽  
Vol 8 ◽  
pp. 205031212098245
Author(s):  
Assefa Tola Gemeda ◽  
Lemma Demissie Regassa ◽  
Adisu Birhanu Weldesenbet ◽  
Bedasa Taye Merga ◽  
Nanti Legesse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Associated Factors ◽  
Antihypertensive Medication ◽  
Meta Analysis ◽  
Group Analysis ◽  
Hypertensive Patients ◽  
Pooled Prevalence

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.

scholarly journals Comparison of Interventions to Improve Long-Term Medication Adherence Across Different Clinical Conditions: A Systematic Review With Network Meta-Analysis

2018 ◽  
Vol 9 ◽  
Author(s):  
Andrea Torres-Robles ◽  
Elyssa Wiecek ◽  
Fernanda S. Tonin ◽  
Shalom I. Benrimoj ◽  
Fernando Fernandez-Llimos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Clinical Conditions

scholarly journals The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis

10.2196/17776 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17776 ◽  
Author(s):  
Ran Li ◽  
Ning Liang ◽  
Fanlong Bu ◽  
Therese Hesketh
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Mobile Health ◽  
Meta Analysis ◽  
Self Management ◽  
Narrative Synthesis ◽  
Management Behavior ◽  
Mhealth Intervention

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

scholarly journals The Effect of Smartphone App–Based Interventions for Patients With Hypertension: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Hongxuan Xu ◽  
Huanyu Long
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Blood Pressure Reduction ◽  
Pooled Analysis ◽  
Lifestyle Changes ◽  
Mean Difference ◽  
Smartphone App ◽  
Smartphone Intervention

BACKGROUND Hypertension is a major cause of cardiovascular disease, which is the leading cause of premature death. People with hypertension who do not comply with recommended treatment strategies have a higher risk of heart attacks and strokes, leading to hospitalization and consequently greater health care costs. The smartphone, which is now ubiquitous, offers a convenient tool to aid in the treatment of hypertension through the use of apps targeting lifestyle management, and such app-based interventions have shown promising results. In particular, recent evidence has shown the feasibility, acceptability, and success of digital interventions in changing the behavior of people with chronic conditions. OBJECTIVE The aim of this study was to systematically compile available evidence to determine the overall effect of smartphone apps on blood pressure control, medication adherence, and lifestyle changes for people with hypertension. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. Databases were searched to identify randomized controlled trials related to the influence of an app-based intervention in people with hypertension. Data extracted from the included studies were subjected to a meta-analysis to compare the effects of the smartphone app intervention to a control. RESULTS Eight studies with a total of 1657 participants fulfilled the inclusion criteria. Pooled analysis of 6 studies assessing systolic blood pressure showed a significant overall effect in favor of the smartphone intervention (weighted mean difference –2.28, 95% CI –3.90-0.66). Pooled analysis of studies assessing medication adherence demonstrated a significant effect (<i>P</i>&lt;.001) in favor of the intervention group (standard mean difference 0.38, 95% CI 0.26-0.50) with low heterogeneity (I<sup>2</sup>=0%). No difference between groups was demonstrated with respect to physical activity. CONCLUSIONS A smartphone intervention leads to a reduction in blood pressure and an increase in medication adherence for people with hypertension. Future research should focus on the effect of behavior coaching apps on medication adherence, lifestyle change, and blood pressure reduction.

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