Berardinelli Daniela, Conti Alessio, Hasnaoui Anis, Casabona Elena, Martin Barbara, Campagna Sara, Dimonte Valerio
Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy.
Department of Clinical and Biological Sciences, University of Torino, 10126 Torino, Italy.
Healthcare (Basel). 2024 Nov 22;12(23):2337. doi: 10.3390/healthcare12232337.
: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. : This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. : Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. : A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. : Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns.
用药依从性差会导致不良健康后果并增加医疗成本。一些医疗保健专业人员提供干预措施以提高用药依从性,而护士主导的干预措施对慢性病患者的有效性仍不明确。本研究旨在评估护士主导的干预措施对改善慢性病成年患者用药依从性的有效性。检索了五个数据库(MEDLINE、CINAHL、EMBASE、Cochrane图书馆、SCOPUS),未设时间限制。纳入评估护士主导的干预措施对患有一种或多种慢性病的成年患者用药依从性影响的研究。仅针对单一急性疾病的干预措施被排除。共纳入22项研究,涉及5975名参与者。在七项涉及对心力衰竭患者(n = 2)、慢性髓性白血病患者(n = 1)、高血压患者(n = 1)和多病共存患者(n = 1)进行面对面访视的研究中,有五项报告了依从性有统计学显著改善;在九项采用面对面访视和电话随访相结合方法的研究中,有四项涉及心力衰竭患者(n = 1)、高血压患者(n = 1)、冠心病患者(n = 1)和多病共存患者(n = 1),报告了依从性有统计学显著改善。在六项研究中,有一项远程干预措施在改善用药依从性方面有效。基于平板电脑的患者教育与护士主导的教育课程之间未发现统计学显著差异。动机性方法被发现是促进患者用药依从性最常用的策略之一。护士主导的面对面访视可能对改善慢性病患者的用药依从性有效。然而,由于目前测量用药依从性的方法可能无法准确捕捉患者行为和药物消费模式,因此需要进一步研究。