Interventions to improve adherence to lipid lowering medication

摘要: Background Lipid-lowering drugs are widely underused, despite strong evidence indicating they improve cardiovascular end points. Poor patient adherence to a medication regimen can affect the success of lipid-lowering treatment. Objectives To assess effects interventions aimed at improving drugs, focusing on measures and clinical outcomes. Search methods We searched Cochrane Central Register Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO CINAHL up 3 February 2016, trials registers (ANZCTR ClinicalTrials.gov) 27 July 2016. We applied no language restrictions. Selection criteria We evaluated randomised controlled adherence-enhancing for in adults an ambulatory setting with variety measurable outcomes, such as treatment changes serum lipid levels. Two teams review authors independently selected studies. Data collection analysis Three extracted assessed data, following criteria outlined by Handbook Systematic Reviews Interventions. quality using GRADEPro. Main results For this updated review, we added 24 new studies meeting eligibility 11 from prior updates. have therefore included 35 studies, randomising 925,171 participants. Seven including 11,204 individuals compared rates those intensification care intervention (e.g. electronic reminders, pharmacist-led interventions, healthcare professional education patients) versus usual over short term (six months or less), were pooled meta-analysis. Participants group had better than receiving (odds ratio (OR) 1.93, 95% confidence interval (CI) 1.29 2.88; 7 studies; participants; moderate-quality evidence). A separate analysis also showed improvements long-term (more six months) (OR 2.87, CI 1.91 4.29; 663 high-quality Analyses effect total cholesterol LDL-cholesterol levels positive intensified both short- follow-up. Over term, decreased mean 17.15 mg/dL (95% 1.17 33.14; 4 430 low-quality evidence) 19.51 8.51 30.51; 333 long 17.57 14.95 20.19; 2 127 Included did not report usable data health outcome indications, adverse costs/resource use, so could pool these outcomes. each study bias methods described In general, risk assessment revealed low selection bias, attrition reporting bias. There was unclear relating blinding most studies. Authors' conclusions The our demonstrates that improves adherence, well Healthcare systems which implement team-based may be successful medicines.