Study: No single way to ensure patients take meds

There are no surefire ways to get patients to take medications as directed. However, systematically assembling evidence across reviews allows identification of effective or promising interventions to improve consumers’ use of medicines use, as well as those for which the evidence indicates ineffectiveness or uncertainty, according to a study published in The Cochrane Library.

Rebecca Ryan, PhD, of the Centre for Health Communication and Participation at the Australian Institute for Primary Care & Aging at La Trobe University, in Bundoora, Australia, and colleagues conducted a systematic review of the effects of interventions which target healthcare consumers to promote evidence-based prescribing for, and medicines' use by, consumers, including reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects.

“Many strategies exist to help people to use medicines safely and effectively, but research in the area is not well organized across diseases, populations and settings. This can make it difficult for policy makers, health professionals and others to find and use the evidence about what works and what does not,” Ryan and colleagues wrote.

Strategies included information provision, support for behavior change, risk minimization and skills acquisition, and no single strategy improved medicine use outcomes across all diseases, populations or settings, or for all outcomes, the researchers noted.

Strategies that appear promising to improve medicines use included medicines self-monitoring and self-management, simplified dosing and direct involvement of pharmacists in medicines management. Other strategies such as reminders; education combined with self-management skills training, counseling or support; financial incentives; and strategies involving lay health workers showed promise, although effects were less consistent, the authors wrote.

Some strategies, such as providing information or education as single interventions, may be ineffective, but for many strategies there is not enough evidence to decide how effective or ineffective they are, the group continued.

“Decision-makers faced with implementing interventions to improve consumers’ medicines use can use this overview to inform these decisions and also to consider the range of interventions available; while researchers and funders can use this overview to determine where research is needed,” the researchers concluded. “However, the limitations of the literature relating to the lack of evidence for important outcomes and specific populations ... should also be considered.”

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