Abstract
BackgroundInterventions to improve medication adherence are diverse and complex. Consequently, synthesizing this evidence is challenging. We aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions.MethodsWe used data from 60 studies in a completed systematic review to examine the combinations of nine behavior change techniques (increasing knowledge, increasing awareness, changing attitude, increasing self-efficacy, increasing intention formation, increasing action control, facilitation, increasing maintenance support, and motivational interviewing) among studies demonstrating improvements in adherence.ResultsAmong the 60 studies, 34 demonstrated improved medication adherence. Among effective studies, increasing patient knowledge was a necessary but not sufficient technique. We identified seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 %) of the effective studies. The intervention configuration that included increasing knowledge and self-efficacy was the most empirically relevant, accounting for 17 studies (50 %) and uniquely accounting for 15 (44 %).ConclusionsThis analysis extends the completed review findings by identifying multiple combinations of behavior change techniques that improve adherence. Our findings offer direction for policy makers, practitioners, and future comparative effectiveness research on improving adherence.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0255-z) contains supplementary material, which is available to authorized users.
Highlights
Interventions to improve medication adherence are diverse and complex
We present findings from our use of qualitative comparative analysis (QCA) to identify the combinations of patient-directed Behavior change technique (BCT) that were necessary or sufficient, or both, for improving medication adherence across the diverse body of evidence in the Agency for Healthcare Research and Quality (AHRQ) review previously completed by members of our study team
We used a novel method within an existing systematic review to identify several configurations of BCTs among interventions to improve medication adherence in outpatients on chronic medications
Summary
Interventions to improve medication adherence are diverse and complex. synthesizing this evidence is challenging. The strongest support was found for self-management of medications for short-term improvement in adherence for asthma patients; collaborative care or case management programs for short-term improvement of adherence and to improve symptoms for patients taking depression medications; and pharmacist-led approaches for hypertensive patients to improve systolic blood pressure. This synthesis did not evaluate the effectiveness of the various BCTs used across this body of evidence
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have