Leah L Zullig1,2, Katherine Ramos3,4, Hayden B Bosworth5,6,7,8. 1. Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA. 2. Department of Population Health Sciences, Duke University, Durham, NC, USA. 3. Geriatric, Research, Education and Clinical Center (GRECC), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham VA Health Care System, GRECC (182), Durham, NC, 27705, USA. 4. Center for Aging and Human Development, Duke University, Durham, NC, USA. 5. Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA. hayden.bosworth@duke.edu. 6. Department of Population Health Sciences, Duke University, Durham, NC, USA. hayden.bosworth@duke.edu. 7. School of Nursing, Duke University, Durham, NC, USA. hayden.bosworth@duke.edu. 8. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA. hayden.bosworth@duke.edu.
Abstract
PURPOSE OF REVIEW: The purpose of this review was to synthesize research findings from recently published randomized controlled trials (RCTs) targeting any phase of medication adherence, from initiation to discontinuation, among patients with coronary heart disease (CHD). RECENT FINDINGS: We identified successful strategies and promising practices for improving medication adherence among patients diagnosed with CHD. Consistent intervention strategies included the following: (1) facilitating patient-provider communication, (2) using mHealth technologies with emphasis on two-way communication, (3) providing patient education in tandem with lifestyle and behavioral counseling, and (4) providing psychosocial support. Regarding medication adherence phases, all studies examined implementation (i.e., taking medications as prescribed over time) and one also addressed treatment initiation (i.e., beginning a new medication). None identified addressed discontinuation. Studies varied by use of objective, self-report, and a combination of outcome measures with a greater number reporting only subjective measures of adherence. Key findings remained mixed in supporting specific intervention designs or delivery formats. This review addresses available data of promising practices for improving CHD medication adherence. Future studies are needed to examine intervention effectiveness, scalability, and durability of observed outcome effects.
PURPOSE OF REVIEW: The purpose of this review was to synthesize research findings from recently published randomized controlled trials (RCTs) targeting any phase of medication adherence, from initiation to discontinuation, among patients with coronary heart disease (CHD). RECENT FINDINGS: We identified successful strategies and promising practices for improving medication adherence among patients diagnosed with CHD. Consistent intervention strategies included the following: (1) facilitating patient-provider communication, (2) using mHealth technologies with emphasis on two-way communication, (3) providing patient education in tandem with lifestyle and behavioral counseling, and (4) providing psychosocial support. Regarding medication adherence phases, all studies examined implementation (i.e., taking medications as prescribed over time) and one also addressed treatment initiation (i.e., beginning a new medication). None identified addressed discontinuation. Studies varied by use of objective, self-report, and a combination of outcome measures with a greater number reporting only subjective measures of adherence. Key findings remained mixed in supporting specific intervention designs or delivery formats. This review addresses available data of promising practices for improving CHD medication adherence. Future studies are needed to examine intervention effectiveness, scalability, and durability of observed outcome effects.
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