University of Cambridge, Cambridge, United Kingdom.
Indian Institute of Public Health-Delhi, Gurugram, India.
Front Public Health. 2023 Jun 16;11:1194919. doi: 10.3389/fpubh.2023.1194919. eCollection 2023.
Cost-effective interventions that improve medication adherence are urgently needed to address the epidemic of non-communicable diseases (NCDs) in India. However, in low- and middle-income countries like India, there is a lack of analysis evaluating the effectiveness of adherence improving strategies. We conducted the first systematic review evaluating interventions aimed at improving medication adherence for chronic diseases in India.
A systematic search on MEDLINE, Web of Science, Scopus, and Google Scholar was conducted. Based on a PRISMA-compliant, pre-defined methodology, randomized control trials were included which: involved subjects with NCDs; were located in India; used any intervention with the aim of improving medication adherence; and measured adherence as a primary or secondary outcome.
The search strategy yielded 1,552 unique articles of which 22 met inclusion criteria. Interventions assessed by these studies included education-based interventions ( = 12), combinations of education-based interventions with regular follow up ( = 4), and technology-based interventions ( = 2). Non-communicable diseases evaluated commonly were respiratory disease ( = 3), type 2 diabetes ( = 6), cardiovascular disease ( = 8) and depression ( = 2).
Although the vast majority of primary studies supporting the conclusions were of mixed methodological quality, patient education by CHWs and pharmacists represent promising interventions to improve medication adherence, with further benefits from regular follow-up. There is need for systematic evaluation of these interventions with high quality RCTs and their implementation as part of wider health policy.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345636, identifier: CRD42022345636.
在印度，需要采取具有成本效益的干预措施来提高药物依从性，以应对非传染性疾病（NCDs）的流行。然而，在印度等中低收入国家，缺乏评估提高药物依从性策略有效性的分析。我们进行了首次系统评价，评估了旨在提高印度慢性病患者药物依从性的干预措施。
在 MEDLINE、Web of Science、Scopus 和 Google Scholar 上进行了系统搜索。根据符合 PRISMA 的预先确定的方法，纳入了随机对照试验，这些试验包括：涉及 NCD 患者；位于印度；使用任何旨在提高药物依从性的干预措施；并将依从性作为主要或次要结果进行测量。
搜索策略产生了 1552 篇独特的文章，其中 22 篇符合纳入标准。这些研究评估的干预措施包括基于教育的干预措施（n=12）、教育干预措施与定期随访相结合的干预措施（n=4）和基于技术的干预措施（n=2）。评估的常见非传染性疾病包括呼吸疾病（n=3）、2 型糖尿病（n=6）、心血管疾病（n=8）和抑郁症（n=2）。
尽管绝大多数支持这些结论的原始研究的方法学质量参差不齐，但 CHW 和药剂师的患者教育代表了提高药物依从性的有前途的干预措施，定期随访可带来更多益处。需要进行系统评估，包括高质量的 RCT 研究，并将其作为更广泛卫生政策的一部分进行实施。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345636，标识符：CRD42022345636。
