TY - JOUR T1 - Scope of outcomes in trials and observational studies of interventions targeting medication adherence in rheumatic conditions: a systematic review JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190726 SP - jrheum.190726 AU - Ayano Kelly AU - Luke Crimston-Smith AU - Allison Tong AU - Susan J Bartlett AU - Charlotte Bekker AU - Robin Christensen AU - Mary A. De Vera AU - Maarten de Wit AU - Vicki Evans AU - Michael Gill AU - Lyn March AU - Karine Manera AU - Robby Nieuwlaat AU - Shahrzad Salmasi AU - Marieke Scholte-Voshaar AU - Jasvinder A Singh AU - Daniel Sumpton AU - Karine Toupin-April AU - Peter Tugwell AU - Bart van den Bemt AU - Suzanne Verstappen AU - Kathleen Tymms Y1 - 2019/12/15 UR - http://www.jrheum.org/content/early/2019/12/09/jrheum.190726.abstract N2 - Objective Non-adherence to medications is common in rheumatic conditions and associated with increased morbidity. Heterogeneous outcome reporting by researchers compromises the synthesis of evidence of interventions targeting adherence. We aimed to assess the scope of outcomes in interventional studies of medication adherence. Methods We searched electronic databases to February 2019 for published randomized controlled trials and observational studies of interventions with the primary outcome of medication adherence including adults with any rheumatic condition, written in English. We extracted and analyzed all outcome domains and adherence measures with pre-specified extraction and analysis protocols. Results Overall, 53 studies reported 71 outcome domains classified into adherence (1 domain), health outcomes (38 domains) and adherence-related factors (e.g. medication knowledge) (32 domains). We subdivided adherence into three phases: initiation (n=13 studies, 25%); implementation (n=32, 60%); persistence (n=27, 51%); phase unclear (n=20, 38%). Thirty-seven different instruments reported adherence in 115 unique ways (this includes different adherence definitions and calculations, metric and method of aggregation). Forty-one studies (77%) reported health outcomes. The most frequently reported were: medication adverse events (n=24, 45%); disease activity (n=11, 21%); bone turnover markers/physical function/quality of life (each n=10, 19%). Thirty-three studies (62%) reported adherence-related factors. The most frequently reported were: medication beliefs (n=8, 15%); illness perception/medication satisfaction/satisfaction with medication information (each n=5, 9%); condition knowledge/medication knowledge/trust in doctor (each n=3, 6%). Conclusion The outcome domains and adherence measures in interventional studies targeting adherence are heterogeneous. Consensus on relevant outcomes will improve the comparison of different strategies to support medication adherence in rheumatology. ER -