Article

Adherence to multiple cardiovascular (CV) medications is a
cornerstone of coronary heart disease (CHD) management and prevention, but it is
sub-optimal worldwide.
This review aimed to examine whether interventions improve
adherence to multiple CV medications in a CHD population. DESIGN: This study was
based on a systematic review and meta-analysis according to Preferred Reporting
Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. METHODS:
Randomised controlled trials were identified by searching multiple databases and
reference lists. Studies were selected if they evaluated interventions aiming to
improve adherence to multiple CV medications targeting a CHD population and if
they provided an appropriate measure of adherence. Interventions were classified
as complex or simple interventions. Odds ratios (ORs) were calculated and pooled
for a meta-analysis. Risk of bias, heterogeneity and publication bias were also
assessed. RESULTS: Sixteen studies (10,706 patients) were included. The mean age
was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled
analysis, the interventions significantly improved medication adherence (OR 1.52;
95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant
differences based on intervention type (complex vs simple), components categories
and adherence method. There was moderate heterogeneity (I(2) ( )= 61%) across the
studies. After adjusting for publication bias, the effect size was attenuated but
remained significant (OR 1.35; 95% CI 1.09-1.68). CONCLUSION: Interventions to
improve adherence to multiple CV medication in a CHD population significantly
improved the odds of being adherent. Simple one-component interventions might be
a promising way to improve medication adherence in a CHD population, as they
would be easier to replicate in different settings and on a large scale.
CI - (c) The European Society of Cardiology 2016.

Langue : ANGLAIS