Medication adherence interventions that target subjects with adherence problems: Systematic review and meta-analysis

摘要: Abstract Background Inadequate medication adherence is a pervasive, under-recognized cause of poor health outcomes. Many intervention trials designed to improve have targeted adults with problems. No previous reviews synthesized the effectiveness interventions focused on subjects difficulties. Objective This systematic review and meta-analysis findings from studies conducted among Methods Primary research were eligible for inclusion if they tested an increase documented difficulties reported behavior Comprehensive search strategies 13 computerized databases, author ancestry searches, hand searches 57 journals used locate primary research. Participant demographics, characteristics, methodological features reliably coded reports along Effect sizes outcomes calculated as standardized mean differences, random effects models estimate overall effects. Exploratory dichotomous continuous variable moderator analyses employed examine potential associations between effect size sample, intervention, characteristics. Results Data extracted 53 involving 8243 individual study participants. The difference treatment vs. control was 0.301. For pre- post-intervention comparisons, 0.533. Significantly larger associated incorporating prompts take medications than lacking (0.497 0.234). Larger also found that linked taking existing habits compared did not (0.574 0.222). largest measured by pill counts or electronic event monitoring systems. Analysis design identified several risks bias. Statistically significant publication bias detected, but significantly other Conclusions These document targeting individuals problems can modest medication-taking behavior. support use behavioral such linking in challenges. Face-to-face appear be critical patients who experienced past adherence.