Pharmacist‐led interventions to improve medication adherence in older adults: A meta‐analysis

2021 ◽  
Author(s):  
Zachary A. Marcum ◽  
Shangqing Jiang ◽  
Jennifer L. Bacci ◽  
Todd M. Ruppar
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Improve Medication Adherence

scholarly journals Pharmacist-Led Interventions to Improve Medication Adherence in Older Adults: A Meta-Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 335-335
Author(s):  
Zachary Marcum ◽  
Shangqing Jiang ◽  
Jennifer Bacci ◽  
Todd Ruppar
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Effect Size ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Analysis Model ◽  
Improve Medication Adherence ◽  
The Mean

Abstract As pharmacists work to ensure reimbursement for chronic disease management services on the national (e.g., Medicare) level, summative evidence of their impact on important health metrics, such as medication adherence, is needed. The objective of this study was to assess the effectiveness of pharmacist-led interventions on medication adherence in older adults. In April 2020, a comprehensive search was conducted in six databases for publications of randomized clinical trials of pharmacist-led interventions to improve medication adherence in older adults. English-language studies with codable data on medication adherence and diverse adherence-promoting interventions targeting older adults (age 65+) were eligible. A standardized mean difference effect size (intervention vs. control) was calculated for the medication adherence outcome in each study. Study effect sizes were pooled using a random-effects meta-analysis model. Moderator analyses were then conducted to explore for differences in effect size due to intervention, sample, and study characteristics. The primary outcome was medication adherence using any method of measurement. This meta-analysis included 40 unique randomized trials of pharmacist-led interventions with data from 8,822 unique patients (mean age, range: 65 to 85 years). The mean effect size was 0.57 (95% Confidence Interval [CI]: 0.38-0.76). When two outlier studies were excluded from the analysis, the mean effect size decreased to 0.41 (95% CI: 0.27-0.54). Moderator analyses showed larger effect sizes for interventions containing medication education and when interventions had components delivered at least partly in patients’ homes. In conclusion, this meta-analysis found a significant improvement in medication adherence among older adults receiving pharmacist-led interventions.

scholarly journals Psychosocial interventions enhance HIV medication adherence: A systematic review and meta-analysis

2018 ◽  
Vol 25 (10-11) ◽  
pp. 1326-1340 ◽  
Author(s):  
Pascalle Spaan ◽  
Sanne van Luenen ◽  
Nadia Garnefski ◽  
Vivian Kraaij
Keyword(s):  
Medication Adherence ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Controlled Trials ◽  
People Living With Hiv ◽  
Medication Regimen ◽  
Improve Medication Adherence ◽  
Randomized Controlled ◽  
Living With Hiv ◽  
Positive Effect

About 40 per cent of people living with HIV do not sufficiently adhere to their medication regimen, which adversely affects their health. The current meta-analysis investigated the effect of psychosocial interventions on medication adherence in people living with HIV. Databases were systematically searched, resulting in 43 included randomized controlled trials. Study and intervention characteristics were investigated as moderators. The overall effect size indicates a small to moderate positive effect (Hedges’ g = 0.37) of psychosocial interventions on medication adherence in people living with HIV. No evidence for publication bias was found. This meta-analysis study concludes that various psychosocial interventions can improve medication adherence and thereby the health of people living with HIV.

scholarly journals The use of an electronic medication organizer device with alarm to improve medication adherence of older adults with hypertension

2021 ◽  
Vol 19 ◽  
Author(s):  
Liliana Batista Vieira ◽  
Adriano Max Moreira Reis ◽  
Celso de Ávila Ramos ◽  
Tiago Marques dos Reis ◽  
Silvia Helena de Bortoli Cassiani
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Improve Medication Adherence

scholarly journals An Interdisciplinary Collaboration to Improve Hypertension Medication Adherence for Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 229-230
Author(s):  
Jeannie Lee ◽  
Wendy Rogers
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Decision Support ◽  
Medication Adherence ◽  
Cognitive Aging ◽  
Interdisciplinary Collaboration ◽  
Interdisciplinary Team ◽  
Interdisciplinary Teams ◽  
Improve Medication Adherence ◽  
Pressure Feedback

Abstract Hypertension is highly prevalent in older adults (74.5% in ≥60 years) with dire consequences, and adherence to hypertension medications is low (approximately 50%). With increased smartphone use among older adults (81% for 60-69 years, 62% for ≥70 years), technology innovations can improve medication adherence. This symposium highlights the efforts of an innovative interdisciplinary team of experts (clinical, cognitive aging, human factors, health technology) to develop and implement the Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM) system to improve hypertension medication adherence for older adults. MEDSReM is a theory-based, integrated mobile application (app) and companion web portal that educates, supports missed dose decisions, reminds, monitors adherence, and incorporates blood pressure feedback. In this symposium, we describe the interdisciplinary development efforts. Insel et al. will present the theory-based intervention, technology translation, and advancement of the MEDSReM system. Lee et al. will describe the interdisciplinary team and describe the work by the decision support subteam that created the medication formulary and generated an algorithm to guide missed-dose decisions based on pharmacology of aging. Rogers et al. will discuss the education subteam’s development of educational information about hypertension, medications, and adherence for the MEDSReM system. Mitzner et al. will illustrate the instructional support sub-team’s efforts to ensure older adults can interact with both the smartphone app and online portal. Lastly, Hale et al. will describe the user testing subteam’s usability processes including the integration of blood pressure self-monitoring. These efforts will provide insights for other interdisciplinary teams developing technology interventions for older adults.

scholarly journals Change in Medication Adherence and Beliefs in Medicines Over Time in Older Adults

2015 ◽  
Vol 8 (5) ◽  
pp. 39 ◽  
Author(s):  
Elizabeth Unni ◽  
Olayinka O Shiyanbola ◽  
Karen B Farris
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Adherence Behavior ◽  
Improve Medication Adherence ◽  
Lower Baseline ◽  
Item Scale ◽  
Over Time ◽  
Lower Adherence ◽  
Predictors Of Change

<p><strong>OBJECTIVE:</strong> The temporal component of medication adherence is important while designing interventions to improve medication adherence. Thus, the objective of this study was to determine how medication adherence and beliefs in medicines change over time in older adults.</p> <p><strong>METHODS:</strong> A two-year longitudinal internet-based survey among adults 65+ years was used to collect data on medication adherence (Morisky 4-item scale) and beliefs in medicines (Beliefs about Medicines Questionnaire). Paired t-test and one-way ANOVA determined if a change in beliefs in medicines and medication adherence over time was significant. A multiple linear regression was used to determine the significant predictors of change in medication adherence over time.</p> <p><strong>RESULTS:</strong> 436 respondents answered both baseline and follow-up surveys. Among all respondents, there was no significant change in adherence (0.58 ± 0.84 vs. 0.59 ± 0.84; p &gt; 0.05), necessity beliefs (17.13 ± 4.31 vs. 17.10 ± 4.29; p &gt; 0.05), or concern beliefs (11.70 ± 3.73 vs. 11.68 ± 3.77; p &gt; 0.05) over time. For older adults with lower baseline adherence, there was a statistically significant improvement in adherence (1.45 ± 0.70 vs. 0.99 ± 0.97; p &lt; 0.05); but no change in beliefs in medicines over time. The significant predictors of change in medication adherence over time were baseline adherence and baseline concern beliefs in medicines.</p> <p><strong>CONCLUSION:</strong> With baseline adherence and baseline concern beliefs in medicines playing a significant role in determining change in adherence behavior over time, especially in individuals with lower adherence, it is important to alleviate medication concerns at the beginning of therapy for better adherence.</p>

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