TY - JOUR

T1 - 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

AU - Mackridge, Adam

AU - Wood, Eifiona

AU - Hughes, Dyfrig

PY - 2025/3/14

Y1 - 2025/3/14

N2 - BackgroundSuboptimal 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.AimTo identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.MethodMedline, 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.ResultsStrategies 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.ConclusionThere 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.

AB - BackgroundSuboptimal 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.AimTo identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.MethodMedline, 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.ResultsStrategies 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.ConclusionThere 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.

U2 - 10.1007/s11096-025-01885-4

DO - 10.1007/s11096-025-01885-4

M3 - Article

JO - International Journal of Clinical Pharmacy

JF - International Journal of Clinical Pharmacy

SN - 2210-7711

ER -