Researchers still searching for ways to help patients take their meds

By Becky Ham

Clinicians have tried a variety of ways to encourage people to take prescribed medicines, but a new research review says it is still unclear whether many of these interventions have been effective.

Many programs to encourage proper use — from counseling to programs that help use their own medicines in the hospital to drug fact sheets to prescription-refill reminders — have not been studied well enough yet to determine how well they work, according to Sophie Hill, Ph.D., a research fellow at La Trobe University in Australia and co-author of the review.

Some strategies appeared effective, Hill said, but “what is clear from this accumulated evidence is that there is not one single approach that appears effective across all clinical situations or for all outcomes.”

Hill and colleagues’ review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“Many strategies exist to help people to use medicines safely and effectively, but research in the area is not well organized,” Hill said. “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.”

To bring some clarity to this picture, the Cochrane researchers analyzed 37 systematic reviews on medicine-use interventions. Just over half of the studies reported how effective the interventions were in helping patients take their medications as prescribed.

“Studies consistently show that up to half of patients do not take their medicines as prescribed,” Hill said, making adherence a cause for concern.

Sometimes it’s difficult for patients to adhere to a medication schedule — and sometimes patients deliberately do not take their medicines as prescribed. Strategies need to address this phenomenon as well, said Rebecca Snead, executive vice president and CEO of the National Alliance of State Pharmacy Associations.

Some patients might stop taking their medications if they do not get “immediate gratification from it,” Snead said. “They may think that all medicine should have that antibiotic, pain-reliever type of effect.”

Others, worried about the costs of prescription drugs, could stop taking their medicines to stay within their monthly budgets. Prescribers often are not aware of this problem, Snead said. “The reality of it is that a prescriber doesn’t know often what the burden is going to be” for a patient, she said. “He or she doesn’t know about the person’s co-pay, if they have prescription insurance or if the drug is covered on their formulary.”

Simplified doses, assessment of medicines by pharmacists and programs to help patients manage their medicines all showed some promise with regard to adherence and other health outcomes, Hill and her colleagues concluded, but other programs including counseling, reminders and even financial incentives had less consistent effects on medication use.

Very few of the systematic reviews looked at how these strategies fared with children, caregivers and people taking multiple medications for multiple conditions, Hill said.

More information: Ryan R, et al. Consumer-oriented interventions for evidence-based prescribing and medicines use: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2011, Issue 5.

add to favorites email to friend print save as pdf

Related Stories

Telehealth keeps asthmatics out of hospitals

Oct 06, 2010

Health care delivered via telephone or Internet might not improve the quality of life for people with mild asthma, but it could keep those with severe asthma out of the hospital, a new evidence review finds.

For a less biased study, try randomization

Apr 13, 2011

A new review of existing research confirms that the so-called “gold standard” of medical research — the randomized controlled study — provides a safeguard against bias.

Recommended for you

Patient-centered medical homes reduce costs

14 hours ago

The patient-centered medical home (PCMH), introduced in 2007, is a model of health care that emphasizes personal relationships, team delivery of care, coordination across specialties and care settings, quality ...

New mums still excessively sleepy after four months

15 hours ago

(Medical Xpress)—New mums are being urged to be cautious about returning to work too quickly, after a QUT study found one in two were still excessively sleepy four months after giving birth.

It's time to address the health of men around the world

16 hours ago

All over the world, men die younger than women and do worse on a host of health indicators, yet policy makers rarely focus on this "men's health gap" or adopt programs aimed at addressing it, according to an international ...

User comments