RT Journal Article
SR Electronic
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
FD The Journal of Rheumatology
SP 1565
OP 1574
DO 10.3899/jrheum.190726
VO 47
IS 10
A1 Ayano Kelly
A1 Luke Crimston-Smith
A1 Allison Tong
A1 Susan J. Bartlett
A1 Charlotte L. Bekker
A1 Robin Christensen
A1 Mary A. De Vera
A1 Maarten de Wit
A1 Vicki Evans
A1 Michael Gill
A1 Lyn March
A1 Karine Manera
A1 Robby Nieuwlaat
A1 Shahrzad Salmasi
A1 Marieke Scholte-Voshaar
A1 Jasvinder A. Singh
A1 Daniel Sumpton
A1 Karine Toupin-April
A1 Peter Tugwell
A1 Bart van den Bemt
A1 Suzanne Verstappen
A1 Kathleen Tymms
YR 2020
UL http://www.jrheum.org/content/47/10/1565.abstract
AB Objective. Nonadherence 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 prespecified 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 3 phases: initiation (n = 13 studies, 25%), implementation (n = 32, 60%), persistence (n = 27, 51%), and 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.