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Interventions for improving medication adherence in community-dwelling older people with multimorbidity: A systematic review and meta-analysis

医学 荟萃分析 心理干预 奇纳 人口 梅德林 心理信息 科克伦图书馆 家庭医学 老年学 物理疗法 内科学 精神科 环境卫生 政治学 法学
作者
Chen Yang,Song Zhu,Diana Lee,Sek Ying Chair
出处
期刊:International Journal of Nursing Studies [Elsevier BV]
卷期号:126: 104154-104154 被引量:21
标识
DOI:10.1016/j.ijnurstu.2021.104154
摘要

Multimorbidity is highly prevalent amongst older people. Compared with those with a single disease, older people with multimorbidity are more susceptible to medication nonadherence, which causes adverse health outcomes and increased health care costs. The effectiveness of interventions for improving medication adherence in this population is still unclear.To evaluate the effectiveness of interventions to improve medication adherence for community-dwelling older people with multimorbidity.Systematic review and meta-analysis.Ten databases: Airiti Library, China National Knowledge Infrastructure, Cochrane CENTRAL, EBSCO CINAHL, OVID EMBASE, OVID MEDLINE, Proquest Central, PsycINFO, Wanfang Database and Web of Science Core Collection.Studies evaluating the effects of interventions on medication adherence in community-dwelling older people with multimorbidity were included. Two researchers independently performed the study selection, data extraction and risk assessment. Intervention effects were pooled by random-effects meta-analysis.A total of nine studies with 3,292 participants were included. Studies on self-management interventions revealed a significant and modest improvement in medication adherence (n = 3 studies; SMD 0.52; 95% CI 0.04 to 0.99; p = 0.03, I2 = 43%). Studies using electronic health interventions demonstrated a small yet significant benefit for medication adherence (n = 2 studies; SMD 0.22; 95% CI 0.02 to 0.42; p = 0.03, I2 = 0%). There was no pooled significant effect of medication review on medication adherence (n = 4 studies; SMD -0.03; 95% CI -0.21 to 0.15; p = 0.74, I2 = 68%). Most of the studies failed to yield a significant improvement in patients' health outcomes.Self-management interventions and electronic health interventions might be effective in improving medication adherence for older people with multimorbidity. Future adherence interventions are needed to demonstrate improvements in medication adherence and health outcomes.CRD42020150500.
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