Gohil Shrey, Majd Zahra, Sheneman Jared C, Abughosh Susan M
Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, Houston, TX, USA.
University of Houston, College of Pharmacy, Houston, TX, USA.
Patient Educ Couns. 2022 Jul;105(7):1731-1742. doi: 10.1016/j.pec.2021.10.017. Epub 2021 Oct 15.
To summarize existing literature examining interventions to enhance medication adherence and their effectiveness in enhancing care for inflammatory bowel disease (IBD) patients.
This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. PubMed and Embase were searched for studies from June 2014 to Dec 2020. Only the studies published in English were included.
Our systematic literature search identified 488 published articles. Seventeen studies with a total of 7073 patients were included. Out of seventeen different interventions, five were classified as educational, eight as multicomponent, three as behavioral and one as cognitive behavioral. Adherence was measured using patient self-report, administrative/pharmacy claims data, and electronic monitoring devices/pill dispensing systems. Twelve out of seventeen interventions showed a statistically significant improvement in medication adherence including three educational, seven multicomponent, one behavioral and one cognitive behavioral intervention.
Multicomponent interventions demonstrated the greatest success in IBD patients in promoting medication adherence. Future research should focus on a multidisciplinary approach to design multicomponent interventions to optimize treatment adherence and enhance long-term clinical outcomes.
While stand-alone strategies have demonstrated effectiveness in improving adherence, better outcomes may be achieved by combining multiple strategies.
总结现有关于增强药物依从性干预措施及其在改善炎症性肠病（IBD）患者护理方面有效性的文献。
本综述按照系统评价和Meta分析的首选报告项目（PRISMA）声明进行。检索了PubMed和Embase数据库中2014年6月至2020年12月的研究。仅纳入以英文发表的研究。
我们的系统文献检索共识别出488篇已发表文章。纳入了17项研究，共7073例患者。在17种不同的干预措施中，5种归类为教育类，8种为多组分类，3种为行为类，1种为认知行为类。使用患者自我报告、行政/药房报销数据以及电子监测设备/药丸分发系统来衡量依从性。17种干预措施中有12种在药物依从性方面显示出统计学上的显著改善，包括3种教育类、7种多组分类、1种行为类和1种认知行为类干预措施。
多组分干预措施在促进IBD患者药物依从性方面取得了最大成功。未来的研究应侧重于采用多学科方法设计多组分干预措施，以优化治疗依从性并改善长期临床结局。
虽然单一策略已证明在提高依从性方面有效，但通过组合多种策略可能会取得更好的效果。
