Universität zu Köln

Matthes, Jan ORCID: 0000-0003-2754-1555 and Albus, Christian (2014). Improving Adherence With Medication A Selective Literature Review Based on the Example of Hypertension Treatment. Dtsch. Arztebl. Int., 111 (4). S. 41 - 50. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: A common problem among patients with chronic diseases is poor adherence with prescribed medication. Studies have shown that certain interventions can improve adherence and clinical outcomes. Methods: We selectively searched the PubMed database for publications on the treatment of hypertension that contained the terms adherence, drug, treatment, outcome, hypertension, and randomized controlled trial. Results: The interventions studied were highly varied, ranging from the use of calendar blister packs to complex patient education programs. 62% of the studies that we identified documented an improvement in adherence after an intervention (median Cohen`s d = 0.52). In 92% of cases, improved adherence was associated with a significant improvement in clinical end points (median Cohen`s d = 0.34). Conclusion: The promotion of adherence to prescribed medication is clearly desirable. Studies on the treatment of hypertension have shown that attempts to improve adherence often fail. In most studies, however, improved adherence led to better clinical outcomes. Simplification of drug regimens (e.g., reducing the number of pills taken per day) is the single most effective way to promote adherence. Moreover, the findings of studies on the treatment of hypertension and other diseases suggest that shared decision-making should be the basis of physician-patient discussions about medication. Suitable medications can also be chosen in order to maximize safety and efficacy even if adherence is incomplete. It would also be desirable for studies on the promotion of adherence to be carried out in Germany, under the specific conditions that prevail in our national health-care system.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Matthes, Jan UNSPECIFIED orcid.org/0000-0003-2754-1555 UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-448254
DOI:	10.3238/arztebl.2014.0041
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	111
Number:	4
Page Range:	S. 41 - 50
Date:	2014
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-PRESSURE CONTROL; RANDOMIZED CONTROLLED-TRIAL; SHARED DECISION-MAKING; PATIENT COMPLIANCE; ANTIHYPERTENSIVE MEDICATION; CARDIOVASCULAR RISK; DRUG-THERAPY; CARE PROGRAM; IMPACT; INTERVENTION Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44825