Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service

Adam Mackridge, Eifiona Wood, Dyfrig Hughes

Research output: Contribution to journalReview articlepeer-review

Abstract

Background
Suboptimal medication adherence is a major determinant of treatment outcome. Between a third and a half of prescribed medicines for long-term conditions are not taken as intended, the reasons for which are numerous and multifaceted. Improving medication adherence should optimise therapeutic outcomes.

Aim
To identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.

Method
Medline, CINAHL and EMBASE were searched on 11 May 2022 for publications added since 11 January 2013, along with citation searches linked to Nieuwlaat’s 2014 Cochrane review. An umbrella review was undertaken of meta-analyses and systematic reviews of empirical research to identify and describe interventions that improve medication adherence. Effective interventions were assessed for their implementation potential.

Results
Strategies to improve medication adherence follow common themes. Fifteen reviews and meta-analyses were identified, and interventions were grouped into eight types. These included using pharmacists to provide interventions; providing face to face interventions; using combination formulations; providing reminders and prompting mechanisms; giving feedback on individual adherence rates; promoting positive habits; using strategies to enhance self-management and positive behaviours; and using interventions in parallel.

Conclusion
There are several readily implementable intervention approaches with demonstrable effectiveness based on systematic review or meta-analysis evidence. However, owing to the diverse evidence base in this field, and the significant risk of bias in many studies, further work is needed to understand the comparative value of different interventions and their impact on patient-oriented outcomes.
Original languageEnglish
Pages (from-to)640-653
Number of pages14
Journal International Journal of Clinical Pharmacy
Volume47
Early online date14 Mar 2025
DOIs
Publication statusPublished - Jun 2025

Keywords

  • Community Pharmacy Services
  • Humans
  • Medication Adherence
  • Patient-Centered Care
  • Pharmacists
  • State Medicine/standards
  • United Kingdom/epidemiology

Fingerprint

Dive into the research topics of 'Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service'. Together they form a unique fingerprint.

Cite this