Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies.
Int J Clin Pract
; 72(1)2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-29193650
ABSTRACT
INTRODUCTION:
Cardiovascular medications are effective in prevention of cardiovascular diseases (CVD); however, medication non-adherence contributes to morbidity and mortality.OBJECTIVE:
This systematic review and meta-analysis aims to summarise the evidence regarding the relationship between characteristics of drug therapy (pharmacotherapy) and medication non-adherence in the CVD population.METHODS:
Systematic searches in PubMed, LILACS, Academic Search and CINAHL databases for observational studies that enrolled adults with CVD were performed, from January 1960 to December 2015. The meta-analysis tested the association between characteristics of pharmacotherapy and self-reported medication non-adherence outcome, using a random effects model. To investigate heterogeneity, we performed subgroup analysis and sensitivity analysis.RESULTS:
Twenty-four cross-sectional studies and 7 cohort studies were included in this review. Based on 31 studies including 27 441 participants, we performed meta-analyses for all the characteristics of drug therapy that at least 2 studies evaluated, with a total of fourteen meta-analyses. The pooled results showed that studies which evaluate whether participants have insurance or another program that assists with medication costs, but not full coverage (OR = 0.63; 95% CI 0.53-0.74; P < .001; I2 = 0%, P = .938), and a dosing frequency of twice or more daily (OR = 1.38; 95% CI 1.13-1.69; P < .001) were associated with non-adherence. CONCLUSIONS AND RELEVANCE The results of this review suggest that access to insurance or another program that assists with medication costs was a protection factor for non-adherence. On the other hand, a high frequency of dosing was a risk factor for non-adherence. Therefore, these characteristics of pharmacotherapy must be considered to improve medication adherence among CVD patients.
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Base de dados:
MEDLINE
Assunto principal:
Fármacos Cardiovasculares
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Doenças Cardiovasculares
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Adesão à Medicação
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article