{"title":"Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service.","authors":"Adam J Mackridge, Eifiona M Wood, Dyfrig A Hughes","doi":"10.1007/s11096-025-01885-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Suboptimal medication adherence is a major determinant of treatment outcome. Between a third and a half of prescribed medicines for long-term conditions are not taken as intended, the reasons for which are numerous and multifaceted. Improving medication adherence should optimise therapeutic outcomes.</p><p><strong>Aim: </strong>To identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.</p><p><strong>Method: </strong>Medline, CINAHL and EMBASE were searched on 11 May 2022 for publications added since 11 January 2013, along with citation searches linked to Nieuwlaat's 2014 Cochrane review. An umbrella review was undertaken of meta-analyses and systematic reviews of empirical research to identify and describe interventions that improve medication adherence. Effective interventions were assessed for their implementation potential.</p><p><strong>Results: </strong>Strategies to improve medication adherence follow common themes. Fifteen reviews and meta-analyses were identified, and interventions were grouped into eight types. These included using pharmacists to provide interventions; providing face to face interventions; using combination formulations; providing reminders and prompting mechanisms; giving feedback on individual adherence rates; promoting positive habits; using strategies to enhance self-management and positive behaviours; and using interventions in parallel.</p><p><strong>Conclusion: </strong>There are several readily implementable intervention approaches with demonstrable effectiveness based on systematic review or meta-analysis evidence. However, owing to the diverse evidence base in this field, and the significant risk of bias in many studies, further work is needed to understand the comparative value of different interventions and their impact on patient-oriented outcomes.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11096-025-01885-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service.
Background: Suboptimal medication adherence is a major determinant of treatment outcome. Between a third and a half of prescribed medicines for long-term conditions are not taken as intended, the reasons for which are numerous and multifaceted. Improving medication adherence should optimise therapeutic outcomes.
Aim: To identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.
Method: Medline, CINAHL and EMBASE were searched on 11 May 2022 for publications added since 11 January 2013, along with citation searches linked to Nieuwlaat's 2014 Cochrane review. An umbrella review was undertaken of meta-analyses and systematic reviews of empirical research to identify and describe interventions that improve medication adherence. Effective interventions were assessed for their implementation potential.
Results: Strategies to improve medication adherence follow common themes. Fifteen reviews and meta-analyses were identified, and interventions were grouped into eight types. These included using pharmacists to provide interventions; providing face to face interventions; using combination formulations; providing reminders and prompting mechanisms; giving feedback on individual adherence rates; promoting positive habits; using strategies to enhance self-management and positive behaviours; and using interventions in parallel.
Conclusion: There are several readily implementable intervention approaches with demonstrable effectiveness based on systematic review or meta-analysis evidence. However, owing to the diverse evidence base in this field, and the significant risk of bias in many studies, further work is needed to understand the comparative value of different interventions and their impact on patient-oriented outcomes.
期刊介绍:
The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences.
IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy.
IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor.
International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy .
Until 2010 the journal was called Pharmacy World & Science.