An education-behavioural intervention improves adherence to statins

Kardas, Przemysław

doi:10.2478/s11536-013-0170-9

Cited by 2 publications

(11 citation statements)

References 24 publications

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“…Most (20/32) of the included studies were conducted in North America [ 21 – 24 , 26 – 30 , 32 , 36 , 37 , 43 , 45 – 51 ], with 9 conducted in Europe [ 20 , 31 , 34 , 35 , 38 , 39 , 41 , 42 , 44 ] and 3 in Asia [ 25 , 33 , 40 ]. The median sample size for the intervention group was 202 (range: 15–29,042) and the median study duration was 12.0 months (range: 3 months–2 years).…”

Section: Resultsmentioning

confidence: 99%

“…Of those that did, half indicated that statins were prescribed for secondary CVD prevention [ 20 – 22 , 25 , 33 , 44 – 46 , 48 ]. Other indications included primary hypercholesterolemia [ 35 ], diabetes [ 28 , 32 ] and elevated CVD risk [ 36 , 37 , 39 , 51 ]. Five studies selected patients based on poor adherence to statin therapy [ 24 , 26 , 31 , 36 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were seven RCTs (or similar) and one prospective study that included multiple, face-to-face, cognitive education sessions in their interventions (Table 1 ) [ 33 – 35 , 38 , 40 – 42 , 48 ]. All of these, except for Eussen et al [ 41 ], reported a statistically significant improvement in adherence to statins (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Patient-Centered Interventions to Improve Adherence to Statins: A Narrative Synthesis of Systematically Identified Studies

Jörntén‐Karlsson

Pintat

Molloy‐Bland

et al. 2016

Drugs

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Poor adherence to statins increases cardiovascular disease risk. We systematically identified 32 controlled studies that assessed patient-centered interventions designed to improve statin adherence. The limited number of studies and variation in study characteristics precluded strict quality criteria or meta-analysis. Cognitive education or behavioural counselling delivered face-to-face multiple times consistently improved statin adherence compared with control groups (7/8 and 3/3 studies, respectively). None of four studies using medication reminders and/or adherence feedback alone reported significantly improved statin adherence. Single interventions that improved statin adherence but were not conducted face-to-face included cognitive education in the form of genetic test results (two studies) and cognitive education via a website (one study). Similar mean adherence measures were reported for 17 intervention arms and were thus compared in a sub-analysis: 8 showed significantly improved statin adherence, but effect sizes were modest (+7 to +22 % points). In three of these studies, statin adherence improved despite already being high in the control group (82–89 vs. 57–69 % in the other studies). These three studies were the only studies in this sub-analysis to include cognitive education delivered face-to-face multiple times (plus other interventions). In summary, the most consistently effective interventions for improving adherence to statins have modest effects and are resource-intensive. Research is needed to determine whether modern communications, particularly mobile health platforms (recently shown to improve medication adherence in other chronic diseases), can replicate or even enhance the successful elements of these interventions while using less time and fewer resources.Electronic supplementary materialThe online version of this article (doi:10.1007/s40265-016-0640-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Patient-Centered Interventions to Improve Adherence to Statins: A Narrative Synthesis of Systematically Identified Studies

Jörntén‐Karlsson

Pintat

Molloy‐Bland

et al. 2016

Drugs

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“…In fact, the intervention was codesigned by community pharmacists and primary care doctors with the goal of establishing a standard intervention that would be able to be implemented in both of these health professional fields. In the case of interventions where reminders were used, there are studies where adherence improves after intervention in the community pharmacy and in the hospital setting . On the other hand, when the intervention is about providing education on the importance of adherence to treatment and other issues related to the disease, there are studies that do not find improvement at the end of the study in community pharmacy nor in the hospital environment .…”

Section: Discussionmentioning

confidence: 99%

“…In the case of interventions where reminders were used, there are studies where adherence improves after intervention in the community pharmacy 19,42 and in the hospital setting. 45,46 On the other hand, when the intervention is about providing education on the importance of adherence to treatment and other issues related to the disease, there are studies that do not find improvement at the end of the study in community pharmacy 21 nor in the hospital environment. 22,26 Data suggest that in order to obtain the improvement in adherence, identifying the cause of nonadherence and choosing the most appropriate intervention for the patient's situation should be part of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial

Oñatibia-Astibia

Malet-Larrea

Larrañaga

et al. 2019

Health Services Research

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Objective To evaluate the impact of health professionals’ intervention on adherence to statins, the influence on total cholesterol levels, and lifestyle patterns in patients with hypercholesterolemia and analyze the differences according to the center of recruitment. Study Setting Forty‐six community pharmacies and 50 primary care centers of Spain. Study Design Randomized controlled trial design (n = 746). Patients were assigned into adherent (ADH) or nonadherent group depending on their initial adherence to statins. Nonadherent patients were randomly assigned to intervention (INT) or nonintervention (NOINT) group. Patients enrolled in the INT group received an intervention depending on the cause of nonadherence. Patients in the ADH and NOINT groups received usual care. Intention‐to‐treat (ITT) analysis was performed with multiple imputation to replace the missing data. Data Collection Adherence, total cholesterol levels, and lifestyle behaviors. Findings The odds of becoming adherent during the 6 months was higher in the INT group compared to the NOINT group (OR = 1,49; 95% CI: 1.30‐1.76; P < 0.001), especially in the community pharmacy group (OR = 2.34; 95% CI: 1.81‐3.03; P < 0.001). Adherent patients showed lower values of total cholesterol compared with nonadherent patients at baseline (ADH: 200.3 mg/dL vs NOADH: 216.7 mg/dL; P < 0.001) and at the endpoint (ADH: 197.3 mg/dL vs NOADH: 212.2 mg/dL; P < 0.001). More patients enrolled in the INT group practices exercise at the end of the study (INT: +26.6 percent; P = 0.002), and a greater number of patients followed a diet to treat hypercholesterolemia (+30.2 percent; P < 0.001). Conclusions The intervention performed by health professionals, especially by community pharmacists, improved adherence to statins by hypercholesterolemic patients, and this improvement in adherence was accompanied by a reduction in total cholesterol levels and a healthier lifestyle.

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An education-behavioural intervention improves adherence to statins

Abstract: Abstract

Cited by 2 publications

References 24 publications

Patient-Centered Interventions to Improve Adherence to Statins: A Narrative Synthesis of Systematically Identified Studies

Patient-Centered Interventions to Improve Adherence to Statins: A Narrative Synthesis of Systematically Identified Studies

Tailored interventions by community pharmacists and general practitioners improve adherence to statins in a Spanish randomized controlled trial

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