Patientreported outcomes for pediatric adherence and self. The correlation was even stronger in studies that did not. Many studies have shown that some degree of non adherence occurs universally, in rich and poor countries alike, and is even seen in lifethreatening diseases 1,2. Good outcomes from chronic diseases largely depend on the degree of patient adherence to treatment.
Depression is a risk factor for noncompliance with medical treatment. Apr 17, 2007 patients non adherence to medical treatment remains a persistent problem. Innovations in theory and practice are badly needed. Longterm use of evidencebased medications is recommended by international guidelines for the management of stable coronary artery disease, however, non adherence to medications is common. This meta analysis aims to systematically evaluate the impact of medication adherence on clinical outcomes in patients with stable coronary artery disease. In medicine, patient compliance also adherence, capacitance describes the degree to which a patient correctly follows medical advice. For example, a metaanalysis of studies examining social support and patient adherence to medication showed that art adherence was 1. Adherence has been found to have positive and significant effects on treatment outcomes. Association between adherence to pharmacotherapy and outcomes in type 2 diabetes. Adherence to wakefulness promoting medication in patients. A metaanalysis included in this study showed positive associations between the quality of clinicianpatient communications and adherence to medical treatment in 125 of 127 studies analysed and showed the odds of patient adherence was 1. Health literacy and adherence to medical treatment in. A metaanalysis comparing 48week treatment outcomes of single.
Existed studies of antiepileptic medication non adherence in. A metaanalysis of the association between adherence to drug. Metaanalysis of interventions to improve medication adherence. Interventions for improving patients adherence to medical treatment adherence to medical treatment plays a key role in maintaining or improving clinical outcomes. Interventions to enhance medication adherence in chronic. Health beliefs, disease severity, and patient adherence. Evidence is strong in the case of adherence to recommended medical treatment. Download citation patient adherence and medical treatment outcomes. Background approximately 20% to 50% of patients are not adherent to medical therapy.
Health beliefs, disease severity, and patient adherence citeseerx. Depression is a risk factor for noncompliance with medical. The medicare prescription drug, improvement, and modernization act of 2003 public law 108173 established the requirements that part d plan sponsors must meet with regard to drug utilization management, quality assurance, and medication therapy management mtm. Ulcerative colitis patients cite treatment regimen complexity, tablet quantity and dose frequency as key negative influencers of adherence. Adherence has been defined as the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behavior to produce a therapeutic result. Patients became comfortable disagreeing with the providers recommendations or asking clarifying questions patients became active participants in the development of their treatment plan, which they believed was essential for highquality care lambertkerzner a, havranek ep, plomondon me, et al. The who, in its 2003 report on medication adherence, states that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatment. Patientcentered priorities for improving medication. Patient adherence in the treatment of depression volume 180 issue 2 s. Nonadherence to treatment among dialysis patients is widely recognized in the. In medical treatment, the term nonadherence describes the failure of a patient to follow. Objective to evaluate the relation between adherence to drug therapy, including placebo, and mortality. Promoting treatment adherence through motivational.
A mckinsey study points to areas pharmaceutical companies can address to combat this longstanding industry issue. Numerous empirical studies from various populations and settings link patient treatment adherence to physician patient communication. Patient adherence and medical treatment outcomes a meta. Physician communication and patient adherence to treatment a metaanalysis. Considering only two studies of patients with asthma were included in this meta. Seven of these eight studies 17,18,19,20,21,22,23 reported patient adherence as a dichotomous outcome threshold defined per study protocol. The impact of medication adherence on clinical outcomes of. Antiepileptic medication non adherence can be a reason for long term hospitalization, repeated emergency seizure attacks, increased health care cost and frequent absence of work due to poor seizure control. Results showed that on average 26% more patients had a better treatment outcome when adherence rates were high. The challenge of patient adherence pubmed central pmc. In our study, significant improvement in medication adherence was shown only among copd patients. B impact of patient education and counseling interventions on tb treatment outcomes.
Hence, non adherence to medical treatment, especially in chronic conditions, is considered a major public health concern. Barriers to treatment adherence for dialysis patients. Pdf quality healthcare outcomes depend upon patients adherence to recommended treatment regimens. Sixtythree studies assessing patient adherence and outcomes of medical treatment were found involving medical regimens recommended by a nonpsychiatrist physician, and measuring patient adherence and health. Pdf physician communication and patient adherence to. Poor treatment adherence represents a complex and challenging problem of international healthcare systems, as it has a substantial impact on clinical outcomes and patient safety and constitutes an important financial burden. Medication therapy management effective health care program. Health literacy and adherence to medical treatment in chronic.
The purpose of this study was to assess the association between medication adherence and risk of cardiovascular disease cvd, allcause mortality, and hospitalization in type 2 diabetes. Objective a previous study suggests an association between poor medication adherence and excess mortality in chronic disease. Objective depression is common in patients with diabetes and is associated with worse treatment outcomes. Patient adherence in the treatment of depression the. The health and economic consequences of poor adherence. Numerous empirical studies from various populations and settings link patient treatment adherence to physicianpatient communication.
A large body of empirical data exists on the prediction of patient adherence from subjective and objective assessments of health status and disease severity. The centers for education and research on therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient centered perspective and to explore the potential of patient centered medication management to improve chronic disease treatment. To use metaanalytic techniques to assess average effect sizes in studies of. Metaanalysis allows estimates of the overall effects both in correlational research and in experimental interventions involving the training of physicians communication skills. This study aimed to estimate the prevalence rate of medication nonadherence occurring at patients home. Existed studies of antiepileptic medication non adherence in ethiopia have reported. Moreover, the impact of adherence on patients outcomes seems stronger in chronic disorders.
Jan 19, 2018 according to the world health organization, medication adherence can have a more direct impact on patient outcomes than the specific treatment itself. Mtm services include providing education and counseling, improving medication. In this metaanalysis, better adherence to medication in adults with type 2 diabetes is associated with reduced rates of allcause mortality and hospitalization. We used metaanalysis to examine the relationship between depression and treatment nonadherence in patients with type 1 and type 2 diabetes. To use meta analytic techniques to assess average effect sizes in studies of. Patients dwelling at home are at risk of medication nonadherence which is directly associated with poor treatment outcomes. Social support and patient adherence to medical treatment. Further studies are needed to investigate the impact of adherence on outcomes in these patients.
Aug 27, 2019 adherence describes how a patient follows a medical regime recommended by a healthcare provider. Economic impact of medication non adherence by disease groups. Variations in patients adherence to medical recommendations. Adherence is a factor in the outcome of medical treatment, but the strength and moderators of the adherence outcome association have not been systematically assessed. A metaanalysis of the use of electronic reminders for. The cost consequences of unsuccessful patient communication. Jun 29, 2006 objective to evaluate the relation between adherence to drug therapy, including placebo, and mortality. The medical outcomes study mos measures of patient. Nonadherence is a pervasive underrecognized cause of poor health outcomes. The problem of poor adherence to medical treatment is a wellrecognized problem in the literature. Using metaanalytic procedures to synthesize changes in patientcentered.
Review methods predefined criteria were used to select studies reporting mortality among participants with good and poor adherence. Many interventions to improve patient adherence are unsuccessful and sound theoretical foundations are lacking. This makes nonadherence to medications one of the largest and most expensive disease categories. An estimated 20% to 50% of patients do not take their medications as prescribed and are said to be nonadherent or noncompliant with therapy. Inadequate medication adherence limits effective treatment for many diseases. Research design and methods we searched medline and. We aim to evaluate the effectiveness of a patientcentered medical home model called wellnet versus that of standard care on blood pressure bp outcomes among hypertensive patients.
Multidrugresistant tuberculosis treatment adherence in. Taking into account unfilled prescriptions, missed doses, and inadequate persistence, patient medication adherence averages only 50%. Interventions for improving patients adherence to medical. Impact of mobile applications on adherence to cancer. The relative effectiveness of adherence interventions has been analyzed and. Association between adherence to pharmacotherapy and outcomes. Physician communication and patient adherence to treatment jstor. As might be expected, adherence rates varied noticeably among the disease categories examined. Adherence to medication is an essential component of health outcome,9 11 so by increasing medication adherence we can also improve patient outcomes. Medication adherence based on pill count two studies was higher in the str group 92.
Jul 03, 2018 b impact of patient education and counseling interventions on tb treatment outcomes. A metaanalysis of the association between adherence to. Although the scope of this meta analysis was limited by the number of studies that examined patient centered outcomes in relation to medication adherence interventions, it does suggest that these interventions can improve patient knowledge, increase quality of life, and decrease symptoms. Adherence is behaviour, although it is often confused with its outcome. Dec 17, 2019 treatment adherence is approximately 50% across pediatric conditions. Although it remains to be determined whether treating depression will result in improved patient adherence, the recognition of depression as a significant risk factor for noncompliance with medical treatment carries the potential to improve medical practice, reduce patient disability, enhance patient functioning, and improve health care. The literature contains sufficient evidence on the relationship between aspects of communication and the outcomes of patient satisfaction, recall and compliance for positive correlations to be made.
Adherence interventions and outcomes of tuberculosis. The scope of the study is patient adherence to medical treatment in the cure and care sector. Epilepsy is the common neurological disorder in the world, affecting approximately 50 million people. Research design and methods we conducted an electronic search on many electronic. Patient reported outcomes pros are the most common method of measuring adherence and selfmanagement across research and clinical contexts. Review methods predefined criteria were used to select studies reporting mortality among participants with good and poor adherence to drug. Adherence survey treatment of endstage renal disease esrd, or kidney failure is demanding, multifaceted and complex, requiring strict patient adherence to treatment protocols to achieve favorable health outcomes and a satisfactory quality of life. Health beliefs, disease severity, and patient adherence a metaanalysis m. Sixtythree studies assessing patient adherence and outcomes of medical treatment were found involving medical regimens recommended by a nonpsychiatrist physician, and measuring patient adherence. Jan 12, 2002 the term compliance should be replaced by co. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, selfdirected exercises, or therapy sessions. Patientcentered outcomes of medication adherence interventions.
Association between adherence to pharmacotherapy and. Patient adherence also called compliance is defined as the degree to which patients follow treatment recommendations prescribed by their clinician or health care provider. A meta analysis of the use of electronic reminders for patient adherence to medication in chronic disease care. Physician communication and patient adherence to treatment. Adherence to medication is a crucial part of patient care and indispensable for reaching clinical goals. Background adherence is a factor in the outcome of medical treatment, but the strength and moderators of the adherenceoutcome association have not. When patients fail to follow prescribed medical regimens, outcomes suffer. Beyond its impact on clinical outcomes, poor adherence also seems to have a negative effect on socioeconomic wellbeing. Communication between patients and their physicians, and physician training on how to communicate, have a significant positive effect on patients following medical treatments and prevention recommendations. Methods we calculated a metaanalysis of 569 studies reporting adherence to medical treatment prescribed by a nonpsychiatrist physician, and 164 studies providing correlations between adherence and patients age, gender, education, and incomesocioeconomic status.
A metaanalysis adherence is a factor in the outcome of medical treatment, but the. Assessing patient adherence to chronic diseases treatment. Effectiveness of a patientcentered medical home model of. Although medical researchers have demonstrated many efficacious medical treatments to improve health outcomes, a recent report by the institute of medicine identified a disquieting discrepancy between present treatment success rates and those thought to be achievable.