A Systematic Review of Controlled Trials: Can Patient Adherence to Antibiotics Be Improved Through Pharmaceutical Communication-Based Interventions?

BACKGROUND

Patient adherence to antibiotics is vital to ensure treatment efficiency.

OBJECTIVE

To evaluate the impact of pharmacist communication-based interventions on patients' adherence to antibiotics.

METHODS

A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for systematic review (PRISMA) checklist and flow diagram. Controlled trials were included.

DATABASES

PubMed, Cochrane Library, SciELO, and Google Scholar. Quality, risk of bias, and confidence in cumulative evidence were evaluated.

RESULTS

Twenty-one trials were selected, with better patient adherence for the intervention than the control group. However, statistically significant differences were only found in two-thirds of these trials. The use of educational leaflets, personalized delivery of antibiotics, follow-up measures, and structured counseling were among the most impactful and significant interventions. The fact that community and/or hospital pharmacists were required to intervene in both groups (e.g., intervention vs. control/usual care) may explain that statistically significant differences were not achieved in all trials. Moderate quality issues and/or risk of bias were detected in some of the evaluated trials. The cumulative evidence was classified as high to moderate, which was considered acceptable.

CONCLUSION

It seems that more intense and structured pharmacist interventions can improve patient adherence to antibiotics.