Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials

K. Santo; S. Kirkendall; T.-L. Laba; J. Thakkar; R. Webster; J. Chalmers; C.K. Chow; J. Redfern

doi:10.1177/2047487316638501

Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials

K. Santo^*, S. Kirkendall, T.-L. Laba, J. Thakkar, R. Webster, J. Chalmers, C.K. Chow, J. Redfern

^*Corresponding author for this work

Research output: Contribution to journal › Review article › Research › peer-review

41 Citations (Scopus)

Abstract

Background:

Adherence to multiple cardiovascular (CV) medications is a cornerstone of coronary heart disease (CHD) management and prevention, but it is sub-optimal worldwide. This review aimed to examine whether interventions improve adherence to multiple CV medications in a CHD population.

Design:

This study was based on a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Methods:

Randomised controlled trials were identified by searching multiple databases and reference lists. Studies were selected if they evaluated interventions aiming to improve adherence to multiple CV medications targeting a CHD population and if they provided an appropriate measure of adherence. Interventions were classified as complex or simple interventions. Odds ratios (ORs) were calculated and pooled for a meta-analysis. Risk of bias, heterogeneity and publication bias were also assessed.

Results:

Sixteen studies (10,706 patients) were included. The mean age was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled analysis, the interventions significantly improved medication adherence (OR 1.52; 95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant differences based on intervention type (complex vs simple), components categories and adherence method. There was moderate heterogeneity (I ²= 61%) across the studies. After adjusting for publication bias, the effect size was attenuated but remained significant (OR 1.35; 95% CI 1.09-1.68).

Conclusion:

Interventions to improve adherence to multiple CV medication in a CHD population significantly improved the odds of being adherent. Simple one-component interventions might be a promising way to improve medication adherence in a CHD population, as they would be easier to replicate in different settings and on a large scale.

Original language	English
Pages (from-to)	1065-1076
Number of pages	12
Journal	European Journal of Preventive Cardiology
Volume	23
Issue number	10
DOIs	https://doi.org/10.1177/2047487316638501
Publication status	Published - 1 Jul 2016
Externally published	Yes

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title = "Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials",

abstract = "Background:Adherence to multiple cardiovascular (CV) medications is a cornerstone of coronary heart disease (CHD) management and prevention, but it is sub-optimal worldwide. This review aimed to examine whether interventions improve adherence to multiple CV medications in a CHD population. Design:This study was based on a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Methods:Randomised controlled trials were identified by searching multiple databases and reference lists. Studies were selected if they evaluated interventions aiming to improve adherence to multiple CV medications targeting a CHD population and if they provided an appropriate measure of adherence. Interventions were classified as complex or simple interventions. Odds ratios (ORs) were calculated and pooled for a meta-analysis. Risk of bias, heterogeneity and publication bias were also assessed. Results:Sixteen studies (10,706 patients) were included. The mean age was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled analysis, the interventions significantly improved medication adherence (OR 1.52; 95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant differences based on intervention type (complex vs simple), components categories and adherence method. There was moderate heterogeneity (I 2= 61%) across the studies. After adjusting for publication bias, the effect size was attenuated but remained significant (OR 1.35; 95% CI 1.09-1.68). Conclusion:Interventions to improve adherence to multiple CV medication in a CHD population significantly improved the odds of being adherent. Simple one-component interventions might be a promising way to improve medication adherence in a CHD population, as they would be easier to replicate in different settings and on a large scale.",

author = "K. Santo and S. Kirkendall and T.-L. Laba and J. Thakkar and R. Webster and J. Chalmers and C.K. Chow and J. Redfern",

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Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials. / Santo, K.; Kirkendall, S.; Laba, T.-L. et al.
In: European Journal of Preventive Cardiology, Vol. 23, No. 10, 01.07.2016, p. 1065-1076.

Research output: Contribution to journal › Review article › Research › peer-review

TY - JOUR

T1 - Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials

AU - Santo, K.

AU - Kirkendall, S.

AU - Laba, T.-L.

AU - Thakkar, J.

AU - Webster, R.

AU - Chalmers, J.

AU - Chow, C.K.

AU - Redfern, J.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background:Adherence to multiple cardiovascular (CV) medications is a cornerstone of coronary heart disease (CHD) management and prevention, but it is sub-optimal worldwide. This review aimed to examine whether interventions improve adherence to multiple CV medications in a CHD population. Design:This study was based on a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Methods:Randomised controlled trials were identified by searching multiple databases and reference lists. Studies were selected if they evaluated interventions aiming to improve adherence to multiple CV medications targeting a CHD population and if they provided an appropriate measure of adherence. Interventions were classified as complex or simple interventions. Odds ratios (ORs) were calculated and pooled for a meta-analysis. Risk of bias, heterogeneity and publication bias were also assessed. Results:Sixteen studies (10,706 patients) were included. The mean age was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled analysis, the interventions significantly improved medication adherence (OR 1.52; 95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant differences based on intervention type (complex vs simple), components categories and adherence method. There was moderate heterogeneity (I 2= 61%) across the studies. After adjusting for publication bias, the effect size was attenuated but remained significant (OR 1.35; 95% CI 1.09-1.68). Conclusion:Interventions to improve adherence to multiple CV medication in a CHD population significantly improved the odds of being adherent. Simple one-component interventions might be a promising way to improve medication adherence in a CHD population, as they would be easier to replicate in different settings and on a large scale.

AB - Background:Adherence to multiple cardiovascular (CV) medications is a cornerstone of coronary heart disease (CHD) management and prevention, but it is sub-optimal worldwide. This review aimed to examine whether interventions improve adherence to multiple CV medications in a CHD population. Design:This study was based on a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Methods:Randomised controlled trials were identified by searching multiple databases and reference lists. Studies were selected if they evaluated interventions aiming to improve adherence to multiple CV medications targeting a CHD population and if they provided an appropriate measure of adherence. Interventions were classified as complex or simple interventions. Odds ratios (ORs) were calculated and pooled for a meta-analysis. Risk of bias, heterogeneity and publication bias were also assessed. Results:Sixteen studies (10,706 patients) were included. The mean age was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled analysis, the interventions significantly improved medication adherence (OR 1.52; 95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant differences based on intervention type (complex vs simple), components categories and adherence method. There was moderate heterogeneity (I 2= 61%) across the studies. After adjusting for publication bias, the effect size was attenuated but remained significant (OR 1.35; 95% CI 1.09-1.68). Conclusion:Interventions to improve adherence to multiple CV medication in a CHD population significantly improved the odds of being adherent. Simple one-component interventions might be a promising way to improve medication adherence in a CHD population, as they would be easier to replicate in different settings and on a large scale.

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U2 - 10.1177/2047487316638501

DO - 10.1177/2047487316638501

M3 - Review article

SN - 1350-6277

VL - 23

SP - 1065

EP - 1076

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

IS - 10

ER -

Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials

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