Effectiveness of Interventions by Community Pharmacists to Improve Patient Adherence to Chronic Medication: A Systematic Review
- 1 February 2005
- journal article
- review article
- Published by SAGE Publications in Annals of Pharmacotherapy
- Vol. 39 (2), 319-328
- https://doi.org/10.1345/aph.1e027
Abstract
OBJECTIVE: To systematically review the impact of interventions by community pharmacists on patients' adherence with chronic medication.DATA SOURCES: A MEDLINE search (1966–November 30, 2003) and a review of reference sections were done to identify all pertinent English- and German-language journal articles. Search terms included compliance, adherence, persistence, discontinuation, pharmacist, and intervention.STUDY SELECTION AND DATA EXTRACTION: From each relevant study, the following data were extracted: study design, country, disease, number of patients, patients' age and gender, type of intervention, duration of follow-up, method of measurement of adherence and adherence rate, and data concerning the quality of the included studies.DATA SYNTHESIS: A total of 162 studies were identified, of which 18 matched our inclusion criteria. Twelve were randomized controlled trials and 6 were non-crossover single-group trials. Eight studies showed significant improvement of adherence at one or more time points. Eight studies did not show any effect, 7 of which were randomized controlled trials. In most studies, adherence rates at baseline were high compared with rates reported in the general population. Counseling, monitoring, and education during weekly or monthly appointments showed some effect. However, these same types of interventions showed no effect in other studies. The overall quality of the included studies was low.CONCLUSIONS: Currently, it is impossible to identify an overall successful adherence-improving strategy performed by pharmacists. More well-designed and well-conducted studies on the effectiveness of interventions by a community pharmacist to improve patient adherence to chronic medication need to be performed.Keywords
This publication has 39 references indexed in Scilit:
- Effect of a pharmacist-led intervention on diuretic compliance in heart failure patients: a randomized controlled studyJournal of Cardiac Failure, 2003
- Critically Examining Pharmaceutical CareJournal of the American Pharmaceutical Association, 2002
- Four-year persistence patterns among patients initiating therapy with the angiotensin II receptor antagonist losartan versus other antihypertensive drug classesClinical Therapeutics, 2001
- Impact of Pharmacists Providing a Prescription Review and Monitoring Service in Ambulatory Care or Community PracticeAnnals of Pharmacotherapy, 2000
- Asthma drug adherence in a long term clinical trialArchives of Disease in Childhood, 2000
- Compliance in asthmaRespiratory Medicine, 1999
- Ten-year follow-up of antidiabetic drug use, nonadherence, and mortality in a defined population with type 2 diabetes mellitusClinical Therapeutics, 1999
- Hemodialysis morbidity and mortalityCurrent Opinion in Nephrology and Hypertension, 1998
- The Electronic Medication Event MonitorClinical Pharmacokinetics, 1997
- The Effect of Clinical Pharmacy Services on Patients with Essential HypertensionCirculation, 1973