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. 2011 Apr 11;2011:0220.
Ref (type) Population Outcome, Interventions Results and statistical analysis Effect size Favours
Adherence to medication

RCT
230 male steelworkers, with hypertension, not on current treatment. Of 115 in each group, 80 (70%) in education group and 64 (56%) in no education group received drug treatment. These 144 men were analysed Assessment by pill count (compliance defined as the % of medication prescribed that was removed from the bottle; defined as "compliant" if compliance pill count of 80% or more) 6 months follow-up
40/80 (50%) with educational intervention
36/64 (56%) with no health education

Similar rates of adherence between groups, but differences not tested statistically

RCT
110 people, mean age 56 years, started on lipid-lowering medication (fluvastatin) mainly for primary prevention Outcome (% of pills taken assessed by pill count) follow-up at 4 months
88% with educational intervention
84% with usual care
Absolute numbers not reported

P >0.05
Not significant

RCT
110 people, with either newly diagnosed or established treated hypertension, mean age 59 years Adherence assessed by pill count 6 months follow-up
93% with educational intervention
69% with usual care
Absolute numbers not reported

P <0.002
Effect size not calculated educational intervention

RCT
110 people, with either newly diagnosed or established treated hypertension, mean age 59 years Adherence assessed by pill count 2 years' follow-up
96% with educational intervention
56% with usual care
Absolute numbers not reported

P <0.001
Effect size not calculated educational intervention

RCT
4-armed trial
115 people attending a primary care clinic, <70 years old, with hypertension, living near to clinic Self-reported compliance (survey conducted by nurse, household medicated survey, which included questions on drugs and a count of all hypertensive medications; outcome reported as absolute numbers of "good", "fair", and "poor" compliance)
8 people reported as "good", 13 "fair", 8 "poor" with educational intervention
7, 13, 5 people with daily self-monitoring of blood pressure
9, 15, 6 people with education and self-monitoring of blood pressure
7, 12, 10 people with control

RCT reported "no significant difference between groups on compliance"
Not significant

RCT
3-armed trial
417 people with hypertension, on medication Self-reported compliance at interview
91% with educational intervention
90% with no education
Absolute numbers not reported

Reported as not significant
P value not reported
Not significant

RCT
3-armed trial
417 people with hypertension, on medication Analysis of number of tablets prescribed by pharmacy records
69% with educational intervention
68% with no education
Absolute numbers not reported

Reported as not significant
P value not reported
Not significant

RCT
34 people with hypertension on treatment, age 16 years or older (average age 51–56 years), at tertiary care medical centre Self-reported compliance as assessed by interview with questionnaire (score measured on 6-point scale, where 0 = no adherence and 5 = all tablets taken) (possible total score of 30) 6 months
27.53 with educational intervention
24.46 with usual care

P = 0.05
Not significant

RCT
34 people with hypertension on treatment, age 16 years or older (average age 51–56 years), at tertiary care medical centre Physician's assessment of adherence (score measured on 6-point scale, where 0 = no adherence and 5 = all tablets taken) (possible total score of 30) 6 months
29.18 with educational intervention
23.9 with usual care

P = 0.003
Not clear on what basis the physician’s assessment of adherence was made
Effect size not calculated educational intervention

RCT
Participants chosen from database by prescription (rather than diagnosis), 410 people taking benazepril, 1728 taking metoprolol, and 568 taking simvastatin, mean age 55 years (range 20–97 years), with refill of medication every 30 days
Subgroup analysis
Index of compliance was medication possession ratio (MPR), calculated from pharmacy records (MPR defined as the number of days' supply of medication obtained throughout the study period expressed as a ratio against the number of days that should have been supplied) over 9 months
0.71 with educational intervention
0.72 with usual care

Reported as not significant
P value not reported
Not significant

RCT
Participants chosen from database by prescription (rather than diagnosis), 410 people taking benazepril, 1728 taking metoprolol, and 568 taking simvastatin, mean age 55 years (range 20–97 years), with refill of medication every 30 days
Subgroup analysis
Index of compliance was medication possession ratio (MPR), calculated from pharmacy records (MPR defined as the number of days' supply of medication obtained throughout the study period expressed as a ratio against the number of days that should have been supplied) over 9 months
0.74 with educational intervention
0.73 with usual care

Reported as not significant
P value not reported
Not significant

RCT
Participants chosen from database by prescription (rather than diagnosis), 410 people taking benazepril, 1728 taking metoprolol, and 568 taking simvastatin, mean age 55 years (range 20–97 years), with refill of medication every 30 days
Subgroup analysis
Index of compliance was medication possession ratio (MPR), calculated from pharmacy records (MPR defined as the number of days' supply of medication obtained throughout the study period expressed as a ratio against the number of days that should have been supplied) over 9 months
0.73 with educational intervention
0.70 with usual care

Reported as not significant
P value not reported
Not significant

RCT
100 people >70 years of age with chronic stable heart failure, average age 85 years, excluded if mobility disorder or if Folstein's Mental Health test score was <21 Mean compliance, expressed as % of maximum number of tablets that should have been consumed (assessed by pill count)
93% with educational intervention
51% with control
Absolute numbers not reported

P <0.001
Effect size not calculated educational intervention

RCT
245 people with hypertension, on 1 or more medications, attending primary care Adherence measured by electronic medication monitor (electronic lid that registered time and date of opening); mean "timing compliance" defined as number of doses taken at 24- or 12-hour intervals for a once- or twice-daily regimen respectively, divided by the total number of days x 100% 6 months
87% with educational intervention
90% with usual care
Absolute numbers not reported

Adjusted difference between means –1
95% CI –5.1 to +3.1
P = 0.63
Not significant

RCT
314 people with heart failure, 50 years or older, attending primary care, on at least 1 medication Adherence measured by electronic medication monitor (electronic lid that registered time and date of opening); "taking adherence" was defined as the % of prescribed medication taken over 9 months
79% with educational intervention
68% with usual care
Absolute numbers not reported

Difference +11%
95% CI +5.0% to +16.7%
Effect size not calculated educational intervention

RCT
314 people with heart failure, 50 years or older, attending primary care, on at least 1 medication Adherence measured by electronic medication monitor (electronic lid that registered time and date of opening); "scheduling adherence" was defined as day-to-day deviation in timing of dose (e.g., once-daily within 2.4 hours of dose on previous day) over 9 months
53% with educational intervention
47% with usual care
Absolute numbers not reported

Difference +6%
95% CI +0.4% to +11.5%
Effect size not calculated educational intervention

RCT
314 people with heart failure, 50 years or older, attending primary care, on at least 1 medication Adherence measured by electronic medication monitor (electronic lid that registered time and date of opening); "taking adherence" was defined as the % of prescribed medication taken 3 months after intervention had finished
71% with educational intervention
67% with usual care
Absolute numbers not reported

Difference +4%
95% CI –2.8% to +10.7%
Not significant

RCT
314 people with heart failure, 50 years or older, attending primary care, on at least 1 medication Adherence measured by electronic medication monitor (electronic lid that registered time and date of opening); "scheduling adherence" was defined as day-to-day deviation in timing of dose (e.g., once-daily within 2.4 hours of dose on previous day) 3 months after intervention had finished
48.9% with educational intervention
48.6% with usual care
Absolute numbers not reported

Difference +0.3%
95% CI –5.9% to +6.5%
Not significant

RCT
636 adults with hypertension, attending primary care, using hypertensive medication at the time of baseline visit Increase in self-rated adherence (assessed using the 4-item Morisky Self-reported Medication-Taking Scale), reported as a %
9% with nurse-delivered educational/behavioural intervention by protocol, bi-monthly via telephone for 2 years
1% with usual care
Absolute numbers not reported

RCT
190 African-Americans with hypertension (88% women; mean age 54 years), attending community-based primary care practices Adherence measured by electronic pill monitors 12 months
57% with research assistant (RA)-delivered motivational interviewing (MINT) sessions at 3, 6, 9, and 12 months
43% with usual care
Absolute numbers not reported

Difference –14%
95% CI –0.2% to –27%
P = 0.027
Effect size not calculated MINT

RCT
450 people with hypertension attending primary care Overall compliance rate (individuals with a treatment compliance of 80–110%) 24 weeks
83% with educational magazine sent to the patient's home twice monthly
49% with usual care
Absolute numbers not reported

P = 0.0001
Effect size not calculated educational magazine

RCT
450 people with hypertension attending primary care Correct time compliers 24 weeks
74% with educational magazine sent to the patient's home twice monthly
42% with usual care
Absolute numbers not reported

P = 0.0001
Effect size not calculated educational magazine