Tim Mathes|Thomas Jaschinski|Dawid Pieper
Adherence influencing factors – a systematic review of systematic reviews
Witten/Herdecke University|Witten/Herdecke University|Witten/Herdecke University
nonadherence widespread problem adherence crucial point success safe use therapies objective overview review reviews identify factors influence adherence chronic physical conditionsa systematic literature search performed medline embase 1990 july 2013 publications screened according predefined inclusion criteria study quality assessed using amstar process steps carried independently two reviewers relevant data study characteristics results extracted piloted standardized tables one reviewer checked second data synthesized using standardized quantitative approach two reviewersseven systematic reviews included higher education employment seem positive effect adherence ethnic minorities seem less adherent copayments higher medication cost seems negative effect adherence contrast financial statusincome marital status seem influence adherence effect therapy related factors mostly unclear effect number different medications heart failure patients showed tendency effect indicators regime complexity showed consistently negative effect direction duration disease seems effect adherence tendency higher middle age associated higher adherence half reviews effect unclear clear effect physical well mental comorbidity one review showed tendency effect mental comorbidity also gender effect clear effect direction heterogenic within systematic reviewsthe presented overview shows factors potentially influence adherence factors influence adherence consistent factors showed heterogeneous results regarding statistical significance andor effect direction however belonging ethnic minority unemployment cost patient medications showed consistently negative effect adherence indicates social gradient