Faculty of Science, Department of Computer Science, The University of Western Ontario, London, Ontario, Canada.
Value Health. 2013 Jul-Aug;16(5):863-71. doi: 10.1016/j.jval.2013.03.1631. Epub 2013 Jul 4.
To systematically review the evidence on the impact of interventions to improve medication adherence in adults prescribed antihypertensive medications.
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.
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.
系统评价旨在提高服用降压药物的成年人药物依从性的干预措施的效果。
对 1979 年至 2009 年间发表的文献进行电子检索，不限制语言，主要关注提高原发性高血压患者（≥18 岁）对降压药物依从性的干预措施。研究必须将依从性作为干预措施的结果进行测量。我们遵循了报告和综述的标准指南，并对报告的数据进行了叙述性综合。
共确定了 97 篇文章纳入研究；35 篇（35/97，36.1%）研究了直接改善药物依从性的干预措施，其中大多数（58/97，59.8%）为随机对照试验。34 篇（34/97，35.1%）研究报告了药物依从性的统计学显著改善。
讨论/结论：旨在提高患者对药物的了解的干预措施在改善降压治疗的依从性方面具有最大的潜在临床价值。然而，我们发现这些研究存在几个局限性，并建议未来的研究人员关注使用经过验证的依从性测量方法、具有相关依从性和临床结局的精心设计的随机对照试验，以及关于适当设计和分析依从性研究的指南。
