You Are Here    Clinical Guidelines   Archived Guidelines   Adherence (2001)   Table 1

Table 1

Interventions to improve patient adherence to medication courses: Meta-analyses and reviews from the general literature

Author Methods Results
Haynes 124 Systematic review of unconfounded, randomised controlled trials of interventions to support medication adherence. Haynes 124 Systematic review of unconfounded, randomised controlled trials of interventions to support medication adherence. Suitable packages include the provision of care which is convenient for patients, education and counselling, medication alerts, social support, self-assessment, family therapy, and reinforcement during follow-up. Suggests that complex care packages are required in chronic therapy. Notes that even where these measures were most effective they did not result in substantial improvements in adherence, suggesting a need for further research and the evaluation of novel interventions.
Roter 125 Roter 125 Meta-analysis of 153 studies of interventions to improve patient adherence published between 1977 and 1994. Interventions categorised as either educational, behavioural, or affective, and assessed for effect on health outcomes (e.g. blood pressure); direct indicators (e.g. weight change); indirect indicators (e.g. pill count); subjective reports (e.g. patient reports); and utilisation (e.g. appointment-making). Interventions produced the greatest effect on direct and indirect indicators, and smaller effects on health outcomes and utilisation. Patients with chronic disease, and those with mental health problems especially benefited from interventions. No single intervention was found more effective than others. Comprehensive interventions involving cognitive, behavioural and affective elements were more effective than single-focus interventions. Roter 125 Meta-analysis of 153 studies of interventions to improve patient adherence published between 1977 and 1994. Interventions categorised as either educational, behavioural, or affective, and assessed for effect on health outcomes (e.g. blood pressure); direct indicators (e.g. weight change); indirect indicators (e.g. pill count); subjective reports (e.g. patient reports); and utilisation (e.g. appointment-making). Interventions produced the greatest effect on direct and indirect indicators, and smaller effects on health outcomes and utilisation. Patients with chronic disease, and those with mental health problems especially benefited from interventions. No single intervention was found more effective than others. Comprehensive interventions involving cognitive, behavioural and affective elements were more effective than single-focus interventions.