Todd Ruppar|Pamela S. Cooper|David R. Mehr|Janet M. Delgado|Jacqueline Dunbar?Jacob
Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta?Analysis of Controlled Trials
University of Missouri|University of Missouri|University of Missouri|University of Missouri|University of Pittsburgh
background poor adherence medications common problem among heart failure hf patients inadequate adherence leads increased hf exacerbations reduced physical function higher risk hospital admission death many interventions tested improve adherence hf medications overall impact interventions readmissions mortality unknown methods results conducted comprehensive search systematic review intervention studies testing interventions improve adherence hf medications mortality readmission outcome effect sizes es calculated reported data es combined using randomeffects model metaanalysis methods differences true betweenstudy effects expected variation study populations interventions es differences attributed study design sample intervention characteristics assessed using moderator analyses sufficient data available assessed publication bias using funnel plots comprehensive searches yielded 6665 individual citations ultimately yielded 57 eligible studies overall medication adherence interventions found significantly reduce mortality risk among hf patients relative risk 089 95 ci 081 099 decrease odds hospital readmission odds ratio 079 95 ci 071 089 heterogeneity low moderator analyses detect differences es common sources potential study bias conclusions interventions improve medication adherence among hf patients significant effects reducing readmissions decreasing mortality medication adherence addressed regular followup visits hf patients interventions improve adherence key part hf selfcare programs