[논문]Adherence to cardiovascular medication: a review of systematic reviews

Leslie, K H; McCowan, C; Pell, J P

doi:10.1093/pubmed/fdy088

[해외논문] Adherence to cardiovascular medication: a review of systematic reviews 원문보기

Journal of public health, v.41 no.1, 2019년, pp.e84 - e94

Leslie, K H (Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, UK) , McCowan, C (Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Boyd Orr Building, Glasgow, UK) , Pell, J P (Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, UK)

Abstract ▼ AI-Helper

AbstractBackgroundUse of cardiovascular medication has increased over time, especially for primary and secondary prevention, with polypharmacy common.MethodsReview 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.ResultsOf 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.ConclusionsFactors 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.

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