Adherence to medications: evidence synthesis strategies for intervention development

Abstract

Aims: This symposium aims to highlight a range of quantitative and qualitative methodologies used to synthesise evidence relating to the study of medication adherence across medical conditions and to describe how this evidence can be used to inform the systematic development of intervention strategies to improve medication taking behaviour. Rationale: Pharmacotherapy is a key part of the medical management of many chronic illnesses. We know that medication adherence is a behaviour that many people do not successfully maintain in the long term. As this behaviour is amenable to change, developing effective strategies to promote adherence can improve both individual and population health and can enhance the effectiveness and impact of health services, which aligns closely with this year's conference theme. Summary: The 5 speakers will aim to cover key evidence synthesis topics including, estimating the prevalence of non-adherence, meta-synthesis of qualitative studies exploring the experience of using medication and meta-analysis of effectiveness with content analysis of existing intervention studies to improve non-adherence. The first presentation will outline a descriptive meta-analysis to estimate the prevalence of non-adherence in apparent treatment resistant hypertension. The 2nd and 3rd presentations will present qualitative meta-syntheses of the experience of taking medication in Type 2 diabetes and multiple sclerosis. The 4th presentation will present a meta-analysis of the effectiveness of interventions to improve medication adherence and blood pressure in people with hypertension which incorporates content analysis of theoretical domains targeted to estimate their modifying effect on intervention effectiveness. The final presentation ends with a description of the development and pilot evaluation of an intervention to enhance medication adherence. The discussion session will focus on the studies presented, the need to integrate various kinds of evidence and the relative benefits of generic versus disease specific approaches to the development of intervention strategies to improve medication taking behaviour.