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Article
Targeting cardiovascular medication adherence interventions
Meyers Primary Care Institute Publications and Presentations
  • Sarah L. Cutrona, University of Massachusetts Medical School
  • Niteesh K. Choudhry, Harvard Medical School
  • Michael A. Fischer, Harvard Medical School
  • Amber Servi, Brigham and Women’s Hospital
  • Margaret R. Stedman, Brigham and Women’s Hospital
  • Joshua N. Liberman, CVS Caremark
  • Troyen Brennan, CVS Caremark
  • William H. Shrank, Harvard Medical School
UMMS Affiliation
Department of Medicine; Meyers Primary Care Institute
Date
5-1-2012
Document Type
Article
Medical Subject Headings
Medication Adherence
Abstract
OBJECTIVES: To determine whether adherence interventions should be administered to all medication takers or targeted to nonadherers. DATA SOURCES AND STUDY SELECTION: Systematic search (Medline and Embase, 1966-2009) of randomized controlled trials of interventions to improve adherence to medications for preventing or treating cardiovascular disease or diabetes. DATA EXTRACTION: Articles were classified as (1) broad interventions (targeted all medication takers), (2) focused interventions (targeted nonadherers), or (3) dynamic interventions (administered to all medication takers; real-time adherence information targets nonadherers as intervention proceeds). Cohen's d effect sizes were calculated. DATA SYNTHESIS: We identified 7,190 articles; 59 met inclusion criteria. Broad interventions were less likely (18%) to show medium or large effects compared with focused (25%) or dynamic (32%) interventions. Of the 33 dynamic interventions, 6 used externally generated adherence data to target nonadherers. Those with externally generated data were less likely to have a medium or large effect (20% vs. 34.8% self-generated data). CONCLUSION: Adherence interventions targeting nonadherers are heterogeneous but may have advantages over broad interventions. Dynamic interventions show promise and require further study.
Comments

Citation: J Am Pharm Assoc (2003). 2012 May-Jun;52(3):381-97. DOI:10.1331/JAPhA.2012.10211

Related Resources
Link to article in PubMed
PubMed ID
22618980
Citation Information
Sarah L. Cutrona, Niteesh K. Choudhry, Michael A. Fischer, Amber Servi, et al.. "Targeting cardiovascular medication adherence interventions" Vol. 52 Iss. 3 (2012) ISSN: 1544-3450
Available at: http://works.bepress.com/sarah_cutrona/19/