Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, Sydney, Australia.
Health Expect. 2024 Oct;27(5):e70010. doi: 10.1111/hex.70010.
The coexistence of diabetes and hypertension is prevalent due to shared risk factors. Pharmacological treatment has been reported to be effective in managing both conditions. However, treatment effectiveness depends on the extent to which a patient adheres to their treatment. Poor adherence to long-term treatment for chronic diseases is a growing global problem of significant magnitude. Several interventions have been developed to help improve medication adherence in patients with coexisting diabetes and hypertension. This review aimed to determine the characteristics of these interventions and their impact on medication adherence.
A systematic review of the literature was conducted using the PRISMA guidelines and registered in the PROSPERO International Registry of Systematic Reviews. Studies were searched in the databases CINAHL, Embase and Medline to identify relevant articles published during 2012-2023. The search concepts included 'medication adherence', 'hypertension', 'diabetes' and 'intervention'. Studies were included if they were in English and evaluated the impact of an intervention aimed at promoting adherence to medications for both diabetes and hypertension.
Seven studies met the inclusion criteria, with five demonstrating a statistically significant improvement in medication adherence. Of the five studies that improved medication adherence, four were multifaceted and one was a single-component intervention. All successful interventions addressed at least two factors influencing non-adherence. Patient education was the foundation of most of the successful interventions, supported by other strategies, such as follow-ups and reminders.
Multifaceted interventions that also included patient education had a positive impact on medication adherence in patients with coexisting diabetes and hypertension. Improving adherence in patients with coexisting diabetes and hypertension requires a multipronged approach that considers the range of factors impacting medication-taking.
This systematic review provides comprehensive insights into the benefits of patient-centred approaches in intervention development and strengthening. Such patient involvement ensures that medication adherence interventions are more relevant, acceptable and effective, ultimately leading to better health outcomes and more meaningful patient engagement in healthcare research.
由于存在共同的风险因素，糖尿病和高血压同时存在的情况较为普遍。据报道，药物治疗在控制这两种疾病方面是有效的。然而，治疗效果取决于患者对治疗的依从程度。慢性病患者长期治疗的依从性差是一个日益严重的全球性问题。已经开发了几种干预措施来帮助提高同时患有糖尿病和高血压的患者的药物依从性。本综述旨在确定这些干预措施的特点及其对药物依从性的影响。
根据 PRISMA 指南进行了系统的文献综述，并在 PROSPERO 国际系统评价注册中心进行了注册。在 CINAHL、Embase 和 Medline 数据库中搜索相关文章，以确定 2012-2023 年期间发表的相关文章。搜索概念包括“药物依从性”、“高血压”、“糖尿病”和“干预”。如果研究是英文的，并且评估了旨在促进同时治疗糖尿病和高血压药物依从性的干预措施的影响，则纳入研究。
有 7 项研究符合纳入标准，其中 5 项研究显示药物依从性有统计学意义的提高。在提高药物依从性的 5 项研究中，有 4 项是多方面的，有 1 项是单一组成部分的干预。所有成功的干预措施都至少涉及两个影响不依从的因素。患者教育是大多数成功干预措施的基础，辅以其他策略，如随访和提醒。
多方面的干预措施，同时包括患者教育，对同时患有糖尿病和高血压的患者的药物依从性产生了积极影响。提高同时患有糖尿病和高血压的患者的依从性需要采取多管齐下的方法，考虑影响服药的一系列因素。
本系统评价提供了全面的见解，了解以患者为中心的方法在干预措施的开发和加强方面的益处。这种患者参与确保了药物依从性干预措施更具相关性、可接受性和有效性，最终导致更好的健康结果和更有意义的患者参与医疗保健研究。
