eScholarship@UMMS

Title

Targeting cardiovascular medication adherence interventions

Authors

Sarah L. Cutrona, University of Massachusetts Medical SchoolFollow
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

Publication Date

5-1-2012

Document Type

Article

Subjects

Medication Adherence

Disciplines

Health Services Research | Primary Care

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.

DOI of Published Version

10.1331/JAPhA.2012.10211

Source

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

Journal/Book/Conference Title

J Am Pharm Assoc (2003)

Related Resources

Link to article in PubMed

PubMed ID

22618980

Repository Citation

Cutrona, Sarah L.; Choudhry, Niteesh K.; Fischer, Michael A.; Servi, Amber; Stedman, Margaret R.; Liberman, Joshua N.; Brennan, Troyen; and Shrank, William H., "Targeting cardiovascular medication adherence interventions" (2012). Meyers Primary Care Institute Publications and Presentations. 590.
https://escholarship.umassmed.edu/meyers_pp/590