Modes of delivery for interventions to improve cardiovascular medication adherence

UMMS Affiliation

Meyers Primary Care Institute

Publication Date


Document Type



Antihypertensive Agents; Cardiovascular Diseases; Communication; Diabetes Mellitus; Directive Counseling; Humans; Hypoglycemic Agents; Medication Adherence; Patient Discharge; Patient Education as Topic; Pharmacies; *Prescription Drugs; Professional-Patient Relations; Telephone; United States


Health Services Research | Medicine and Health Sciences


OBJECTIVE: To determine the optimal modes of delivery for interventions to improve adherence to cardiovascular medications.

STUDY DESIGN: Systematic review.

METHODS: We conducted systematic searches of English-language, peer-reviewed publications in MEDLINE and EMBASE, 1966 through December 31, 2008. We selected randomized controlled trials of interventions to improve adherence to medications for preventing or treating cardiovascular disease or diabetes. Articles were classified based on mode of delivery of the main intervention as (1) person-independent interventions (mailed, faxed, or hand distributed; or delivered via electronic interface) or (2) person-dependent interventions (nonautomated phone calls, in-person interventions).

RESULTS: We identified 6550 articles. Of these, 168 were reviewed in full and 51 met inclusion criteria. Among person-independent interventions (56% successful), electronic interventions were most successful (67%). Among person-dependent interventions (52% successful), phone calls showed low success rates (38%). In-person interventions at hospital discharge were more effective (67%) than clinic interventions (47%). In-person pharmacist interventions were effective when held in a pharmacy (83% successful), but were less effective in clinics (38%).

CONCLUSIONS: Future medication adherence studies should explore new electronic approaches and in-person interventions at the site of medication distribution. Identifying times of increased patient receptivity to the adherence message such as hospital discharge also will be important.


Am J Manag Care. 2010;16(12):929-42. Link to article on publisher's website

Journal/Book/Conference Title

The American journal of managed care

Related Resources

Link to Article in PubMed

PubMed ID