文章基本信息

标题：Delivery of patient adherence support: a systematic review of the role of pharmacists and doctors
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作者：Malin Andersson ; Sara Garfield ; Lina Eliasson 等
期刊名称：Patient Intelligence
印刷版ISSN：1179-3198
电子版ISSN：1179-3198
出版年度：2014
卷号：6
页码：31-42
DOI：10.2147/PI.S46647
语种：English
出版社：Dove Medical Press Ltd
摘要：We conducted a systematic review of adherence support programs involving doctors and pharmacists. We searched MEDLINE^®, Embase, International Pharmaceutical Abstracts, PsycINFO^®, and CINAHL using the keywords "pharmacist" or "doctor" and "adhere*" or "compli*" and "randomized controlled trials". We found 89 studies involving pharmacists; in contrast, only 14 studies involved doctors. The roles of pharmacists and doctors ranged from providing education and counseling to adjusting treatment. Most interventions that specified a patient group were carried out with patients with chronic conditions (n=79) and only six included short-term treatments. The majority of interventions improved adherence and clinical outcomes to some extent, although the size of effect size was sometimes small. Resource utilization (eg, hospitalization rates, visits to doctors) did not change in the majority of studies that reported it. Few studies included cost analyses. All but one study had high risk of performance bias due to the nature of the interventions, which made it impossible to blind the participants. The majority of studies did not report tailoring the interventions to patient needs and the vast majority of papers did not report taking a concordant patient-centered approach or considering patients' own views and experiences when providing adherence support. In addition, the majority of studies did not describe training for the health care professionals involved in providing adherence support. Providing training for doctors and pharmacists to take a more patient-centered concordant approach would be expected to increase the effectiveness of adherence support further.
关键词：interventions; patient views; patient experiences; patient-centered approach; resource utilization