John E. Zeber|Elizabeth Manias|Allison Williams|David Hutchins|Waka A Udezi|C.S. Roberts|Andrew M. Peterson
A Systematic Literature Review of Psychosocial and Behavioral Factors Associated with Initial Medication Adherence: A Report of the ISPOR Medication Adherence &amp; Persistence Special Interest Group
Baylor Scott & White Health|Central Texas Veterans Health Care System|University of Melbourne|Monash University|Banyan Biomarkers (United States)|University of Benin|Pfizer (United States)|University of the Sciences
objectivesnumerous factors influencing medication adherence chronically ill patients well documented paucity studies concerning initial treatment course experiences represents significant knowledge gap interventions targeting crucial first phase affect longterm adherence outcomes international panel conducted systematic literature review targeting behavioral psychosocial risk factorsmethodseligible published articles presenting primary data 1966 2011 abstracted independent reviewers validated quality instrument documenting terminology methodological approaches factors associated initial adherence problemsresultswe identified 865 potentially relevant publications full review 24 met eligibility criteria mean nichol quality score 472 range 1974 excellent reviewer concordance 0966 p 001 prevalent pharmacotherapy terminology initial primary firstfill adherence articles described following factors commonly associated initial nonadherence patient characteristics n 16 medication class n 12 physical comorbidities n 12 pharmacy copayments medication costs n 12 health beliefs provider communication n 5 issues studies reported health system factors pharmacy information prescribing provider licensure nonpatient dynamicsconclusionsseveral methodological challenges synthesizing findings observed despite implications continued medication adherence clinical outcomes relatively articles directly examined issues associated initial adherence notwithstanding lack information many observed factors associated nonadherence amenable potential interventions establishing solid foundation appropriate ongoing behaviors besides clarifying definitions methodology future research continue investigating initial prescriptions treatment barriers organizational efforts promote better longterm adherence