Adherence to cardiovascular medication: a review of systematic reviews

Leslie, K.H., McCowan, C. and Pell, J.P. (2019) Adherence to cardiovascular medication: a review of systematic reviews. Journal of Public Health, 41(1), e84-e94. (doi: 10.1093/pubmed/fdy088) (PMID:29850883) (PMCID:PMC6459362)

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Background: Use of cardiovascular medication has increased over time, especially for primary and secondary prevention, with polypharmacy common. Methods: Review of published systematic reviews of the factors and outcomes associated with adherence to cardiovascular medication using MEDLINE, Embase, CINAHL and PsycINFO databases. Quality was assessed using the AMSTAR tool. Results: Of 789 systematic reviews identified, 45 met the inclusion criteria and passed the quality assessment; 34 focused on factors associated with adherence, and 11 on outcomes. High heterogeneity, both between and within reviews, precluded meta-analysis and so a pooled estimate of adherence levels could not be derived. Adherence was associated with disease factors, therapy factors, healthcare factors, patient factors and social factors, though with some inconsistencies. In total, 91% of reviews addressing outcomes reported that low adherence was associated with poorer clinical and economic endpoints. Conclusions: Factors from across five key domains relate to non-adherence to cardiovascular medications, and may contribute to poorer clinical outcomes. Interventions to improve adherence should be developed to address modifiable factors and targeted at those at highest risk of non-adherence. Adherence research is highly heterogeneous to-date and efforts to standardize this should be implemented to improve comparability.

Item Type:Articles
Additional Information:Work supported by Medical Research Council (MRC) [MR/N013166/1 to K.H.L.]
Glasgow Author(s) Enlighten ID:Leslie, Kirstin and Mccowan, Professor Colin and Pell, Professor Jill
Authors: Leslie, K.H., McCowan, C., and Pell, J.P.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:Journal of Public Health
Publisher:Oxford University Press
ISSN (Online):1741-3850
Published Online:29 May 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Journal of Public Health 41(1): e84-e94
Publisher Policy:Reproduced under a Creative Commons License

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