Kanika Chaudhri BMedSci (Hons), MD, PhD, Sonali R. Gnanenthiran MBBS, PhD, FRACP, FCSANZ, Anastasia Williams BSci, Madeleine Kearney BMedSci, MPH, Richard O. Day MB BS (Hons), MD, FRACP, Anthony Rodgers MBChB, DPH, FAFPHM, PhD, FAHMS, GAICD, Emily R. Atkins BSci, PhD
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Even though self-reported adherence levels were high, included studies did not report many statistically significant improvements in health outcomes with DAAs.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The use of DAAs can considerably improve medication adherence, with limited data suggesting positive effects on patient outcomes. 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引用次数: 0
摘要
目的自我用药失败是不坚持服药的最常见原因。给药辅助（DAAs）是一种简单而常见的解决方案，以改善口服片剂的意外不依从。它们的范围从分隔的药盒和自动药物分配设备到吸塑包装。本系统综述的目的是总结当前评估DAAs对药物依从性影响的文献。检索MEDLINE、Embase、CINAHL和Cochrane图书馆，从每个数据库的开始到2023年4月。研究选择：与医学研究馆员共同制定了检索策略和关键词列表。两位审稿人独立筛选研究并提取数据。主要结局是评估DAAs对药物依从性的影响。次要结果是评估记录的任何健康结果的变化。该研究按照系统评价和荟萃分析首选报告项目（PRISMA） 2020声明进行报告，并在PROSPERO注册（研究注册号：CRD42018096087）。结果纳入22项随机对照试验。与常规护理相比，自我报告组（95.5%，范围：88% - 100% vs 84.5%，范围：83%-98%）和非自我报告组（88%，范围：54%-100% vs 70%，范围：83%-98%）的中位依从性得到改善。然而，自我报告的依从性在干预组和对照组中都高于非自我报告的依从性。测量的健康结果变化包括心血管结果、血浆水平、疟疾治愈率、住院率、静脉血栓栓塞和贫血。尽管自我报告的依从性水平很高，但纳入的研究并没有报告DAAs在健康结果方面有很多统计学上显著的改善。结论DAAs的使用可以显著提高药物依从性，有限的数据表明对患者预后有积极影响。医疗保健提供者应考虑使用这些辅助作为一个全面的治疗计划的一部分，谁与药物依从性斗争的患者。
Effect of dose administration aids on adherence of self-administered medications: a systematic review
Aim
Failure to self-administer a medication is the most common reason for non-adherence. Dose administration aids (DAAs) are a simple and common solution to improve unintentional non-adherence for oral tablets. They range from compartmentalised pill boxes and automated medication dispensing devices to blister packs. The aim of this systematic review was to summarise the current literature assessing the impact of DAAs on medication adherence.
Data sources
A search of MEDLINE, Embase, CINAHL, and the Cochrane Library was conducted from the beginning of each database until April 2023.
Study selection
A search strategy and keywords list were developed with a medical research librarian. Two reviewers independently screened studies and extracted data. The primary outcome was to assess the effects of DAAs on medication adherence. The secondary outcome was to evaluate the changes in any health outcomes documented. The study was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) 2020 statement and registered with PROSPERO (Study registration: CRD42018096087).
Results
Twenty-two randomised controlled trials were included. Median adherence improved within the intervention groups for self-reported (95.5%, range: 88%–100% vs 84.5%, range: 83%–98%) and non-self-reported (88%, range: 54%–100% vs 70%, range: 83%–98%) adherence compared to usual care. However, self-reported adherence was higher in both intervention and control groups than non-self-reported adherence. Measured changes to health outcomes included cardiovascular outcomes, plasma levels, cure rates for malaria, hospital admissions, venous thromboembolism, and anaemia. Even though self-reported adherence levels were high, included studies did not report many statistically significant improvements in health outcomes with DAAs.
Conclusion
The use of DAAs can considerably improve medication adherence, with limited data suggesting positive effects on patient outcomes. Healthcare providers should consider the use of these aids as part of a comprehensive treatment plan for patients who struggle with medication adherence.
期刊介绍：
The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.
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