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    Targeting cardiovascular medication adherence interventions

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    Authors
    Cutrona, Sarah L.
    Choudhry, Niteesh K.
    Fischer, Michael A.
    Servi, Amber
    Stedman, Margaret R.
    Liberman, Joshua N.
    Brennan, Troyen
    Shrank, William H.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Medicine
    Document Type
    Journal Article
    Publication Date
    2012-05-01
    Keywords
    Medication Adherence
    Health Services Research
    Primary Care
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1331/JAPhA.2012.10211
    Abstract
    OBJECTIVES: To determine whether adherence interventions should be administered to all medication takers or targeted to nonadherers. DATA SOURCES AND STUDY SELECTION: Systematic search (Medline and Embase, 1966-2009) of randomized controlled trials of interventions to improve adherence to medications for preventing or treating cardiovascular disease or diabetes. DATA EXTRACTION: Articles were classified as (1) broad interventions (targeted all medication takers), (2) focused interventions (targeted nonadherers), or (3) dynamic interventions (administered to all medication takers; real-time adherence information targets nonadherers as intervention proceeds). Cohen's d effect sizes were calculated. DATA SYNTHESIS: We identified 7,190 articles; 59 met inclusion criteria. Broad interventions were less likely (18%) to show medium or large effects compared with focused (25%) or dynamic (32%) interventions. Of the 33 dynamic interventions, 6 used externally generated adherence data to target nonadherers. Those with externally generated data were less likely to have a medium or large effect (20% vs. 34.8% self-generated data). CONCLUSION: Adherence interventions targeting nonadherers are heterogeneous but may have advantages over broad interventions. Dynamic interventions show promise and require further study.
    Source

    J Am Pharm Assoc (2003). 2012 May-Jun;52(3):381-97. DOI:10.1331/JAPhA.2012.10211

    DOI
    10.1331/JAPhA.2012.10211
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37180
    PubMed ID
    22618980
    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1331/JAPhA.2012.10211
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