. 2016 Dec 26;34(2):97–113. doi: 10.1007/s40266-016-0426-6

Table 2.

Descriptive summary of included studies

Study (country)	Study type (total participants recruited) [conditions targeted]	Participant characteristics 1. Mean age ± SD 2. Mean no. medications ± SD 3. % of males	Intervention provider	Brief description of interventions	Cut-off point for classifying patients as adherent	Adherence outcome(s)	Clinical outcomes(s)
Barnason et al. [39] (USA)	Pilot RCT (N = 40) [HF]	1. 76.9 ± 6.5 2. 11.3 ± 3.8 3. 65%	Nurse	Hospital transition intervention Telephone counselling and three education modules delivered over two sessions	≥88%	Effect shown (statistically significant) Self-report: adherence, measured via BMQ [45] was higher in the intervention group than control group [F(1,35) = 13.4, p < 0.001]^a	Effect shown (statistically significant) HRQOL: measured via KCCQ [47]. Intervention group had significantly fewer HF-related symptoms that impaired HRQOL [F(1,35) = 9.1, p < 0.05]^a and fewer social limitations [F(1,35) = 8.6, p < 0.05]^a vs. control
Barnason et al. [39] (USA)	Pilot RCT (N = 40) [HF]	1. 76.9 ± 6.5 2. 11.3 ± 3.8 3. 65%	Nurse	Standard care/education only (control) Standard discharge education program	≥88%
O’Carroll et al. [42, 48, 52] (UK)	Pilot RCT (N = 62) [stroke]	1. NR for total sample. Intervention mean: 68.4 ± 11.3; control mean: 70.7 ± 10.5 2. 5.5 ± 2.3 3. 69%	Trained research fellow	Behavioural intervention Two brief sessions consisting of (1) Modification of incorrect illness/medication beliefs; (2) action planning	Participants considered non-adherent if they scored less than maximum on a self-report questionnaire (MARS; maximum score = 25) [83]	Effect shown (statistically significant) Electronic monitoring: intervention group had higher adherence on all three MEMS outcome measures^b than control group, but this was only significant for % doses taken on schedule (mean difference 9.8%; 95% CI 0.2–16.2; p = 0.048)^a Self-report: adherence, measured via MARS [83], improved in both groups at follow-up but a significantly greater improvement was observed in the intervention group (mean difference 0.61; 95% CI 0.1–1.2; p = 0.0027)^a	No effect shown Both groups showed decreases in SBP and DBP but no significant difference between groups^a
O’Carroll et al. [42, 48, 52] (UK)	Pilot RCT (N = 62) [stroke]		Trained research fellow	Control condition Same number of visits as the intervention group but sessions focused on non-medication-related conversation (e.g. impact of a stroke diagnosis)
Ruppar [40] (USA)	Pilot RCT (N = 15) [hypertension]	1. 72.5 ± 8.5 2. 5.8 SD NR 3. 27%	Advanced practice nurse	Behavioural intervention Face-to-face intervention delivering feedback, skills, education and habit adjustment. Delivered biweekly over 8 weeks	>85%	Effect shown (statistically significant) Electronic monitoring: timing adherence measured via MEMS. Treatment group adherence was higher than control group at end of intervention (week 8) (median MA 96.45% vs. 16.4%^c; U = 5.00, p = 0.013).^a Intervention group had a median improvement of +15.4%, control had a change of −5.6% (U = 2.00, p = 0.003)	Effect shown (statistically significant) BP: SBP slightly improved in intervention group. This was statistically significant when compared with control group at week 12 (intervention median 130 mmHg, control median 152 mmHg, U = 4.50, p = 0.008)^a but not at week 20 Intervention had no significant impact on DBP^a
Ruppar [40] (USA)	Pilot RCT (N = 15) [hypertension]	1. 72.5 ± 8.5 2. 5.8 SD NR 3. 27%	Advanced practice nurse	Usual care (control) Varied according to usual healthcare professional. Also received educational materials	>85%
Solomon et al. [38, 44] (USA)	RCT (N = 2097) [osteoporosis]	1. 78.0 (SD NR) 2. 10.4 (SD NR) 3. 6%	Health educator	MI Eight counselling telephone sessions on specific education topics and attitudes/barriers to adherence. Also received educational mailings	NR	No effect shown Pharmacy dispensing records (used to calculate MPR): no statistically significant differences in intervention vs. control groups. Intervention group median MPR 49% (IQR 7–88). Control group median MPR 41% (IQR 1–88%); p = 0.074^d	No effect shown Self-reported fractures: no statistically significant differences noted: intervention 11%, control 11% Self-reported falls: No statistically significant difference in groups: intervention 38%, control 36% General health: No difference between groups in either poor or fair general health categories: intervention 40%, control 41%^d
Solomon et al. [38, 44] (USA)	RCT (N = 2097) [osteoporosis]	1. 78.0 (SD NR) 2. 10.4 (SD NR) 3. 6%	Health educator	Education only (control) Seven educational mailings on various topics (e.g. falls)	NR
Williams et al. [41, 57] (Australia)	Pilot RCT (N = 80) [diabetes with CKD]	1. 67.0 ± 9.6 2. NR for total sample. Intervention mean: 7.6 ± 2.6; Control mean: 7.2 ± 3.3 3. 56.3%	Research nurse	Multifactorial intervention Self-monitoring, medication review, psychosocial DVD and fortnightly MI-based telephone calls for 12 weeks	≥ 80%	No effect shown Pill count: no statistically significant differences reported^a Mean ± SD adherence: Control: 66.0% ± 22 Intervention: 58.4% ± 24.3 Self-report: adherence measured via Morisky’s 4-item questionnaire [46]. No difference reported between intervention and control groups. 65.3% had no change in adherence in terms of forgetting to take the medication	Effect shown (not statistically significant) BP: mean SBP reduction was greater in intervention group but not statistically significant^a Average SBP reduction: intervention −6.9 (95% CI −13.8 to 0.02 Control: −3.0 (95% CI −8.4 to 2.4); p = 0.371 Average DBP reduction: intervention: −2.3 (95% CI −5.2 to 0.7) Control: −3.1 (95% CI −5.9 to −0.3); p = 0.681
Williams et al. [41, 57] (Australia)	Pilot RCT (N = 80) [diabetes with CKD]		Research nurse	Standard care (control) Dependent on individual circumstances. Blood pressure control was a key component	≥ 80%

BMQ Brief Medication Questionnaire, BP blood pressure, CI confidence interval, CKD chronic kidney disease, DBP diastolic blood pressure, F(1,35) F statistic from ANOVA test (degrees of freedom), HF heart failure, HRQOL health-related quality of life, IQR interquartile range, KCCQ Kansas City Cardiomyopathy Questionnaire, MA medication adherence, MARS Medication Adherence Reporting Scale, MEMS Medication Event Monitoring System, MI motivational interviewing, MPR medication possession ratio, NR not reported, p p value (probability associated with selected test statistic), RCT randomised controlled trial, SBP systolic blood pressure, SD standard deviation, U U statistic from Mann–Whitney U test

^aSignificance level p < 0.05

^bPercentage of doses taken, percentage of days that the correct dosage was taken, percentage of doses taken on schedule

^cNon-significant baseline differences noted

^dSignificance level not stated