Impact of Interventions on Medication Adherence and Blood Pressure Control in Patients with Essential Hypertension: A Systematic Review by the ISPOR Medication Adherence and Persistence Special Interest Group
Impact of Interventions on Medication Adherence and Blood Pressure Control in Patients with Essential Hypertension: A Systematic Review by the ISPOR Medication Adherence and Persistence Special Interest Group
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DOI：
10.1016/j.jval.2013.03.1631
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发表时间：
2013-07-01
期刊：
影响因子：
4.5
通讯作者：
Grubisic, Maja
中科院分区：
文献类型：
--
作者：
Gwadry-Sridhar, Femida H.;Manias, Elizabeth;Grubisic, Maja
目的：系统回顾干预措施对改善成人抗高血压药物依从性影响的证据。方法：电子检索1979年至2009年间发表的无语言限制的文章，这些文章的重点是干预措施，以提高原发性高血压患者（>= 18岁）的抗高血压药物依从性。研究必须测量依从性作为干预的结果。我们遵循进行和报告审查的标准准则，并对报告的数据进行了叙述性综合。结果：97篇文章被纳入；35项（35 / 97,36.1%）研究了直接改善药物依从性的干预措施，大多数（58 / 97,59.8%）为随机对照试验。34项研究（97项中的34项，35.1%）报告了药物依从性的统计学显著改善。讨论/结论：旨在提高患者药物知识的干预措施在提高降压治疗依从性方面具有最大的潜在临床价值。然而，我们发现了这些研究的一些局限性，并建议未来的研究人员将重点放在使用经过验证的依从性测量，精心设计的具有相关依从性和临床结果的随机对照试验，以及适当设计和分析依从性研究的指南上。
Objectives: To systematically review the evidence on the impact of interventions to improve medication adherence in adults prescribed antihypertensive medications. Methods: An electronic search was undertaken of articles published between 1979 and 2009, without language restriction, that focused on interventions to improve antihypertensive medication adherence among patients (>= 18 years) with essential hypertension. Studies must have measured adherence as an outcome of the intervention. We followed standard guidelines for the conduct and reporting of the review and conducted a narrative synthesis of reported data. Results: Ninety-seven articles were identified for inclusion; 35 (35 of 97, 36.1%) examined interventions to directly improve medication adherence, and the majority (58 of 97, 59.8%) were randomized controlled trials. Thirty-four (34 of 97, 35.1%) studies reported a statistically significant improvement in medication adherence. Discussion/Conclusions: Interventions aimed at improving patients' knowledge of medications possess the greatest potential clinical value in improving adherence with antihypertensive therapy. However, we identified several limitations of these studies, and advise future researchers to focus on using validated adherence measures, well-designed randomized controlled trials with relevant adherence and clinical outcomes, and guidelines on the appropriate design and analysis of adherence research.