Table 1.

Person-Independent Interventions

Author, Year, Site	Participants, Duration	Intervention	Adherence Measures	Outcomes
Paper information: mailed, faxed or handed out
Smith, 2008 U.S. urban centers	907 patients at hospital discharge post-MI, with β-blocker prescriptions 9 months	2 mailings to patients, PCP’s addressing importance of β-blockers, guidelines.	% of patients with ≥80% of days covered in the 9 months after 1st mailing; pharmacy claims and other electronic data.	Treatment patients were 17% more likely to have 80% of days covered (RR 1.17; CI 1.02 -1.29)
Takala, J, 1983 Southwest Finland	147 untreated HTN patients 2 years	Mailed information on HTN	2 years after intervention, asked if “still under treatment after 2 years.”	Adherent: I: 90% C: 79% P=NS
Video information: mailed or handed out
Powell, KM, 1995	4246 patients on benzapril, metoprolol, simvastatin or estrogen. 9 months	Mailed 1 of 4 educational videotapes	MPR; pharmacy claims	No significant between-group differences in mean MPRs.
Electronic system
Emmett, CL, 2005 Bristol, England.	217 newly diagnosed HTN patients, primary care practices 3 years	Decision analysis (DA) Video and leaflet DA and video, leaflet vs.Usual care	Proportion of patients who report taking all their medications.	DA: 90% Adjusted OR 1.56, CI 0.49-4.96, p=0.45 Video plus leaflet: 94% Adjusted OR 0.53, CI 0.15 -1.84, p=0.32
Friedman, 1996 Boston	299 HTN patients. 6 months	Interactive computer-based home monitoring. Patient self-BP checks, weekly calls to counsel on adherence.	MPR (expressed as percent); home pill count	Mean Δ adherence, unadjusted: C: - 0.4% I: +2.4% p=0.29 Adjusted for baseline adherence: I: 17.7% C: 11.7% p =0.03
Johnson, SS, 2006 Massachusetts and Rhode Island	404 adults with hyperlipidemia. 18 months	Population-based, computer-generated individualized intervention; report mailed to patient	Responses to 5 questions (on Likert scale) summed to create a continuous measure. Calculated Odds of appropriate adherence; Self-report	Adherence as continuous measure: 6 months OR 2.03 p>0.05 18 months OR 2.86 p<0.05
Marquez-Contreras, 2006 Spain	250 HTN patients from primary care centers 6 months	Home automatic BP monitoring	MPR (expressed as %); Adherent is >80%; MEMS	% of adherent patients I: 92 (SD 14.2) C: 74 (SD 18.1) P = 0.0007
Piette, 2000	280 DM patients on hypoglycemic medications. Included Spanish-speaking patients. 12 months	Biweekly automated assessment/ education calls: hierarchically structured messages (positive feedback for adherence, questions on adherence barriers, advice); targeted nurse follow-up calls.	Abbreviated Morisky Index. Patients considered nonadherent if they sometimes forgot or stopped taking medication. Phone interviews, self-report.	I: “substantially less likely” to report adherence problems (P=0.003).
Rosen, 2004 Connecticut	33 DM patients on metformin with <80% adherence 28 weeks	Cue-dose training: given electronic pill caps programmed to beep, instruction on other cues.	Mean MPR (doses needed to be taken on time); electronic pill bottles	16 weeks of intervention: I: 80% C: 60% p = 0.017 No numbers given for 28 weeks (graph provided)

Controls received usual care unless otherwise specified. Duration indicates time until last follow up in which adherence is measured. Confidence interval (CI) is 95% unless otherwise specified.

Unless country is otherwise indicated, study took place in United States.

HTN = hypertension; BP = Blood pressure; CHF = Congestive heart failure; MI = Myocardial Infarct; MEMS = Medication Electronic Monitoring System; PCP = Primary Care Practitioner; MPR = Medication Possession Ratio, medication doses taken divided by doses prescribed. “Morisky scale” has 4 questions: 1 pt for every ‘yes” response. 1.Do you ever forget to take your medication? 2.Are you careless at times about taking your medication? 3. When you feel better, do you sometimes stop taking your medication? 4. Sometimes if you feel worse when you take your medication, do you stop taking it? I = Intervention group; C=control group