Revista Egitania Sciencia - Volume 21 | ARTICLE

Title: EDUCATIONAL INTERVENTIONS TO IMPROVE MEDICATION ADHERENCE IN CHRONIC PATIENTS IN HOSPITAL AMBULATORY: SYSTEMATIC REVIEW

Author: Maria Isabel Barreiro Ribeiro (xilote@ipb.pt), Luís Miguel Fernandes do Nascimento Luís (luis.miguel@ipb.pt), Maria Ângela Gonçalves Rocha de Aragão (angelaragao@ipb.pt), Fátima Roque (froque@ipg.pt)

Publication: Revista Egitania Sciencia - Volume 21

Abstract:
Adherence to medicines treatment is essential to ensure its effectiveness, safety and cost-effectiveness.
This study aims to present a systematic review of the literature on educational and behavioral interventions used to improve adherence to the treatment of chronic outpatients with pathologies whose treatment in Portugal is covered by specific legislation.
A systematic review of the literature was conducted based on studies published in MEDLINE - PubMed on education and counseling interventions used to change behavior in order to improve medication adherence in patients with pathologies for which, in Portugal, medicines are acquired in hospital pharmacies under specific legislation. In this context, all intervention publications, available up to August 31, 2017, were included. Inclusion criteria included: (1) articles written in English, Spanish, Portuguese and French; (2) chronic patients with pathologies whose medication in Portugal is covered by special reimbursement schemes and the medicines are dispensed in hospital pharmacies; (3) educational and behavioral intervention directed at the patient; and, (4) with results about the impact of the interventions on adherence to therapy.
There were 193 publications, of which only 58 obeyed the inclusion criteria. The geographical distribution of the researches was as follows: America (62.1%), Europe (22.4%), Africa (5.2%), Asia (5.2%) and Oceania (5.2%). The most common pathologies were: HIV (65.5%), chronic renal failure (8.6%), inflammatory bowel diseases (6.8%), renal transplants (6.9%), rheumatoid arthritis (3.4%), hepatitis C virus (5.2%), cystic fibrosis (1.7%) and psoriasis (1.7%). Most multidisciplinary interventions had a positive impact on adherence to medicine therapy.
Conclusions: In most studies there was a positive impact of the interventions, revealing the importance of development of intervention studies with patients to improve their adherence to treatment.


Keywords: Medication adherence, Medicines, Ambulatory, Educational interventions, Behavioral interventions, Hospital Pharmacy




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