Vicki S. Conn|Todd Ruppar
Medication adherence outcomes of 771 intervention trials: Systematic review and meta-analysis
University of Missouri|University of Missouri
excellent medication adherence contributes decreases morbidity mortality health care costs although researchers tested many interventions increase adherence results sometimes conflicting often unclear systematic review applied metaanalytic procedures integrate primary research tested medication adherence interventions comprehensive searching completed 2015 located 771 published unpublished intervention studies adherence behavior outcomes randomeffects model analysis calculated standardized mean difference effect sizes metaanalytic moderator analyses examined association adherence effect sizes sample design intervention characteristics analyses conducted 2016 standardized mean difference effect size 0290 comparing treatment control groups calculated moderator analyses revealed larger effect sizes habitbased behavioraltargeted vs cognitivefocused interventions effective interventions delivered facetoface pharmacists administered directly patients effect sizes smaller studies older homeless participants risks bias common effect sizes significantly lower among studies masked data collectors intentiontotreat analyses largest effect sizes reported studies using medication electronic event monitoring pill count medication adherence measures publication bias present comprehensive review date documented although interventions increase adherence much room remains improvement findings suggest health care providers focus intervention content behavioral strategies especially habitbased interventions cognitive strategies designed change knowledge beliefs