Table 9:

Impact on Therapeutic Decisions—Modifications to Medication Regimens, Adherence to Medication Regimens, and Polypharmacy

Author, Year	Measure	Results		Significance
		Guided	Unguided
Modifications
Hall-Flavin et al, 201327	Proportion of patients who had a changea in their medication from baseline	76.8%	44.1%	P < .0001
Winner et al, 201329	Proportion of patients who had a changea in their medication from baseline to end of study	53%	58%	P = .66
Adherence
Winner et al, 201530	Adherenceb at end of follow-up	0.74	0.79	P < .0001
	Change from baseline in adherenceb	0.111	−0.01	P < .0001
	Differences between rates of medication discontinuation before and after the start of study	−7.6%	+0.3%	P < .0001
	Mean time to discontinuation of the initial medication from the start of study	103 days	134 days	P < .0001
Polypharmacy
Hall-Flavin et al, 201228	Difference in mean number of medications per patient at the end of the study compared with the beginning	−2.7 (SD 3.5)c	−2.2 (SD 3.4)c	Difference of the means: 0.5 (SD 6.7)c
Winner et al, 201329	Mean number of psychiatric medications per patient at end of study	1.9	1.7	P = .27
Winner et al, 201530	Increase in average number of medications taken from baseline to end of follow-up	0.88	1.07	P < .0001

Abbreviation: SD, standard deviation.

^aChange included a switch of medication or augmentation in dosage.

^bAdherence was the ratio of the proportion of days on a medication over the total covered days from the index prescription, with discontinuation defined as ≥45 days between refills.

^cCalculated based on data provided in the original study; estimate around the variance is conservative given that within-study correlation was not accounted for. Reported mean medications at baseline in the guided and unguided groups were 4.4 (SD 3.4) and 4.4 (SD 3.13), respectively. Reported mean medications at the end of the study in the guided and unguided groups were 1.7 (SD 0.84) and 2.2 (SD 1.4), respectively.²⁸