. 2011 Dec;8(4):255–271.

Table 2.

Literature review: adherence-enhancement programmes with mixed or no effects, beginning with the most recent (n = 10)


Intervention	Author (year) [country]	Study design	Types of medication	Population/sample characteristics	Measures of adherence outcomes	Main findings for changes in adherence and/or depression

Pharmacy based intervention to improve adherence	Bosmans et al (2007)²⁹ [The Netherlands]	RCT	Non-tricyclic ADMs	151 adult primary care patients treated with new prescription for a non-tricyclic ADM Education and coaching by the pharmacist group = 70 Usual care = 81	Electronic pill container (eDEM); records of precise time container opened	Adherence: no significant differences at 6 months Depressive symptoms: no significant improvements in the SCL depression mean item score Costs: no significant differences over 6 months
Depression education for primary care patients and providers	Azocar and Branstrom (2006)³³ [Australia]	Experimental cohort design	ADM categories not reported	State employees or spouses recruited receiving first ADM Intervention group = 460 Control group = 512	Pharmacy claims data: how consistently medications refilled over 1 year with acute phase the first 6 months and continuance phase the second 6-month period	Adherence: consistency of ADM use over 12 months was not significantly different between groups; the intervention group had fewer gaps in coverage between prescriptions and gaps were shorter Psychotherapy and combination treatment: significant increase in the use of therapy; neither had hospitalisations during the 12-month study period Duration of treatment and therapies: those in the second full course of ADM therapy and psychotherapy were more likely to receive the full course of therapy
Community pharmacists manage depression	Crockett et al (2006)⁴⁵ [Australia]	Parallel groups design with intervention and control groups	ADM categories not reported	106 patients recruited by 32 community pharmacists in rural and remote areas of New South Wales, Australia Intervention group = 46 Control group = 60	Persistence in taking medications at 1 and 2 months	Adherence: high in both groups; no between-group differences, still taking medication at 1 or 2 months Well-being: improvement in well-being in both groups Drug attitudes: improvement in attitudes in both groups with no significant differences between groups
Pharmacist-guided education and monitoring programme (PGEM)	Rickles et al (2005)³⁰ [USA]	Randomised control unblinded, mixed experimental design	ADM categories not reported	63 patients presenting for new ADM prescription at their community pharmacies Intervention group = 28 Usual care = 32	Pharmacy refill data missed doses per day by number of days late between refills and multiplying by 100 for % missed doses	Adherence: no significant group differences. PGEM patients missed fewer doses than the usual care group at 6 months Patient knowledge/beliefs: PGEM significant and positive effect on patient feedback, knowledge, medication beliefs and perceptions of progress Symptoms: no significant difference in symptoms observed at 3 months
Pharmacist interventions to improve depression care and outcomes in primary care	Capoccia et al (2004)⁴⁴ [USA]	Intervention trial	ADM categories not reported	Primary care patients with new episode of depression and started on ADM Intervention group = 41 Control group = 33	Self-report, number days took medication in past month	Adherence: no significant differences between groups at 3, 6, 9 or 12 months Symptoms and quality-of-life: no significant differences in depressive symptoms or quality of life Patient satisfaction and number of provider visits: no significant differences
Remote treatment of depression through tele-psychiatry	Ruskin et al (2004)⁴⁸ [USA]	RCT	ADM categories not reported	Interested patients referred from outpatient VA mental health clinics Intervention remote group = 59 In-person group = 60	Pill count; those who took at least 70% of their medications were deemed adherent	Adherence: no difference in percentage of patients adherent Patient satisfaction with programme: no difference in satisfaction at visits at 4, 6 or 8 months. Satisfaction with psychiatrist higher in patients treated in person Resource consumption/cost: estimated marginal costs to institution higher with remote programme; however, when cost of psychiatrist travel factored in for remote patients, costs were equal
Depression care programme (including education, social support and homework assignments) OPtimind	Vergouwen et al (2005)⁵¹ [The Netherlands]	RCT	Selective serotonin reuptake inhibitors	30 GPs and 211 patients randomised Intervention group = 101 Systematic follow-up group = 110	Adherence evaluated at 2, 6, 10, 14, 18, 22 and 26 weeks with pill count	Adherence: no significant differences in adherence at week 10 or week 26
Educational compliance enhancement programme using (RHYTHMS) by Pfizer Pharmaceuticals and managed by GP	Akerblad et al (2003)⁴⁹ [Sweden]	Randomised controlled design	Sertraline treatment	Patients on sertaline therapy were recruited through mail to GPs Intervention group = 326 Control group = 339	Based upon four approaches: 1. Questions at visits at 4, 12 and 24 weeks 2. Measurable serum levels 3. Appointments kept at 4, 12 and 24 weeks 4. Composite index (items 1–3)	Adherence: no significant between-group differences Remission rates: significantly more patients in intervention group responded at 24 weeks
Telephone disease management programme	Datto et al (2003)⁴⁷ [USA]	Intervention pilot	ADM categories not reported	35 primary care practices in university health system Intervention group = 78 Control group = 123	Assessed as single measure: follow clinician treatment recommendations with respect to initiating treatment, taking medications and increasing doses as recommended	Adherence: no significant effect on improving patient adherence to clinician recommendations. Intervention patients improved significantly more over time Depression symptoms: both groups showed significant changes in CES D scale scores
Information and ongoing interactive programme (RHYTHMS) by Pfizer Pharmaceuticals	Kutcher et al (2002)⁵⁰ [USA]	Randomised blinded, parallel group, controlled trial	Sertraline treatment	269 primary care patients from five Canadian maritime provinces receiving sertraline therapy Intervention group = 85 Non-intervention group = 79	Pill count: proportion of pills not returned and presumed taken to pills dispensed (PNR/PD)	Adherence: no significant between-group differences Remission rates: no significant differences in remission rates, or mean Hamilton Depression Rating Scale scores Satisfaction with treatment: greater satisfaction with information and treatment received