Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis
Abstract Background Non-adherence to medication is a major obstacle in the treatment of depressive disorders. We systematically reviewed the literature to evaluate the effectiveness of interventions aimed at improving adherence to medication among adults with depressive disorders with emphasis on in...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04120-w |
| _version_ | 1811287430099107840 |
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| author | Beatriz González de León Tasmania del Pino-Sedeño Pedro Serrano-Pérez Cristobalina Rodríguez Álvarez Daniel Bejarano-Quisoboni María M. Trujillo-Martín |
| author_facet | Beatriz González de León Tasmania del Pino-Sedeño Pedro Serrano-Pérez Cristobalina Rodríguez Álvarez Daniel Bejarano-Quisoboni María M. Trujillo-Martín |
| author_sort | Beatriz González de León |
| collection | DOAJ |
| description | Abstract Background Non-adherence to medication is a major obstacle in the treatment of depressive disorders. We systematically reviewed the literature to evaluate the effectiveness of interventions aimed at improving adherence to medication among adults with depressive disorders with emphasis on initiation and implementation phase. Methods We searched Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index and Science Citation Index for randomized or non-randomized controlled trials up to January 2022. Risk of bias was assessed using the criteria of the Cochrane Collaboration. Meta-analyses, cumulative and meta-regression analyses for adherence were conducted. Results Forty-six trials (n = 24,324) were included. Pooled estimate indicates an increase in the probability of adherence to antidepressants at 6 months with the different types of interventions (OR 1.33; 95% CI: 1.09 to 1.62). The improvement in adherence is obtained from 3 months (OR 1.62, 95% CI: 1.25 to 2.10) but it is attenuated at 12 months (OR 1.25, 95% CI: 1.02 to 1.53). Selected articles show methodological differences, mainly the diversity of both the severity of the depressive disorder and intervention procedures. In the samples of these studies, patients with depression and anxiety seem to benefit most from intervention (OR 2.77, 95% CI: 1.74 to 4.42) and collaborative care is the most effective intervention to improve adherence (OR 1.88, 95% CI: 1.40 to 2.54). Conclusions Our findings indicate that interventions aimed at improving adherence to medication among adults with depressive disorders are effective up to six months. However, the evidence on the effectiveness of long-term adherence is insufficient and supports the need for further research efforts. Trial registration International Prospective Register for Systematic Reviews (PROSPERO) number: CRD42017065723 . |
| first_indexed | 2024-04-13T03:18:15Z |
| format | Article |
| id | doaj.art-31f0738655d34450a363f694d313a741 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-13T03:18:15Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-31f0738655d34450a363f694d313a7412022-12-22T03:04:50ZengBMCBMC Psychiatry1471-244X2022-07-0122112110.1186/s12888-022-04120-wEffectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysisBeatriz González de León0Tasmania del Pino-Sedeño1Pedro Serrano-Pérez2Cristobalina Rodríguez Álvarez3Daniel Bejarano-Quisoboni4María M. Trujillo-Martín5Unidad Docente Multiprofesional de Atención Familiar y Comunitaria “La Laguna ‑ Tenerife Norte”, Gerencia de Atención Primaria del Área de Salud de TenerifeFundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC)Servicio de Psiquiatría, Hospital Universitario Vall d’HebronCampus Ciencias de La Salud. Área de Medicina Preventiva y Salud Pública. Universidad de La LagunaCentro Superior de Investigación en Salud Pública (CSISP-FISABIO)Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC)Abstract Background Non-adherence to medication is a major obstacle in the treatment of depressive disorders. We systematically reviewed the literature to evaluate the effectiveness of interventions aimed at improving adherence to medication among adults with depressive disorders with emphasis on initiation and implementation phase. Methods We searched Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index and Science Citation Index for randomized or non-randomized controlled trials up to January 2022. Risk of bias was assessed using the criteria of the Cochrane Collaboration. Meta-analyses, cumulative and meta-regression analyses for adherence were conducted. Results Forty-six trials (n = 24,324) were included. Pooled estimate indicates an increase in the probability of adherence to antidepressants at 6 months with the different types of interventions (OR 1.33; 95% CI: 1.09 to 1.62). The improvement in adherence is obtained from 3 months (OR 1.62, 95% CI: 1.25 to 2.10) but it is attenuated at 12 months (OR 1.25, 95% CI: 1.02 to 1.53). Selected articles show methodological differences, mainly the diversity of both the severity of the depressive disorder and intervention procedures. In the samples of these studies, patients with depression and anxiety seem to benefit most from intervention (OR 2.77, 95% CI: 1.74 to 4.42) and collaborative care is the most effective intervention to improve adherence (OR 1.88, 95% CI: 1.40 to 2.54). Conclusions Our findings indicate that interventions aimed at improving adherence to medication among adults with depressive disorders are effective up to six months. However, the evidence on the effectiveness of long-term adherence is insufficient and supports the need for further research efforts. Trial registration International Prospective Register for Systematic Reviews (PROSPERO) number: CRD42017065723 .https://doi.org/10.1186/s12888-022-04120-wMajor Depressive DisorderMeta-analysisSystematic reviewTreatment Adherence |
| spellingShingle | Beatriz González de León Tasmania del Pino-Sedeño Pedro Serrano-Pérez Cristobalina Rodríguez Álvarez Daniel Bejarano-Quisoboni María M. Trujillo-Martín Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis BMC Psychiatry Major Depressive Disorder Meta-analysis Systematic review Treatment Adherence |
| title | Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis |
| title_full | Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis |
| title_fullStr | Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis |
| title_full_unstemmed | Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis |
| title_short | Effectiveness of interventions to improve medication adherence in adults with depressive disorders: a meta-analysis |
| title_sort | effectiveness of interventions to improve medication adherence in adults with depressive disorders a meta analysis |
| topic | Major Depressive Disorder Meta-analysis Systematic review Treatment Adherence |
| url | https://doi.org/10.1186/s12888-022-04120-w |
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