Current Drug Adherence Improvement Methods Ineffective

Study finds a number of measures must be taken to consistently improve medication adherence.

Current methods utilized to improve medication adherence need an overhaul in order for the benefits of these drugs to be realized, a recent study found.

With just approximately half of patients taking their medications as prescribed, researchers from the international Cochrane Library for health information sought to determine what the most effective measures for improving adherence are currently being utilized. The study evaluated 182 trials that used different approaches to enhance medication adherence and patient health.

While the review included a number of high quality studies, the researchers found no clear winning solution, with many of the studies carrying problems in their design.

"The studies varied so much in terms of their design and their results that it would have been misleading to try to come up with general conclusions," said lead researcher Robby Nieuwlaat in a press release. "Based on this evidence, it is uncertain how adherence to medication can be consistently improved. We need to see larger and higher quality trials, which better take in account individual patient’s problems with adherence."

Just 17 out of the 182 trials were found to be of high quality, with each of them combining several different methods. These methods included family member or pharmacist support, education, and counseling.

Even with these measures in place, only 5 of the 17 trials exhibited improved patient health outcomes and medication adherence.

The studies were found to be heterogeneous for patients, medical problems, treatment regimens, adherence interventions, adherence, and clinical outcome measures, with most carrying a high risk of bias, the researchers wrote. The trials with the lowest risk of bias typically involved complex interventions utilizing multiple components to improve adherence through tailored ongoing support from allied health professionals such as pharmacists, who often delivered intense measures.

“Even the most effective interventions did not lead to large improvements in adherence or clinical outcomes,” the researchers wrote.

The overall impact from interventions to improve adherence were inconsistent among the studies, therefore the researchers found it to be unclear how to consistently improve adherence. In order to overcome these barriers, the study found advanced research methods to improve medicine adherence need to be explored.

Among these methods are improved interventions, better adherence measurement techniques, and studies that carry a sufficient number of patients to allow researchers to draw conclusions on clinically important effects, the study noted.

“It’s a real surprise that the vast amount of research that has been done has not moved us further forward in our understanding of how to address this problem,” Dr. David Tovey, editor-in-chief of the Cochrane Library said in a press release. With the costs of health care across the world increasing, we’ve never needed evidence to answer this question more than we do now.”