Table 4. Summary of Interventions to Improve Medication Adherence.
Intervention | Example | Evidence | Strength | Weakness |
---|---|---|---|---|
Education | - | RCT48 | Most beneficial in addressing accidental non-adherence, which results from misunderstanding of the regimen requirements | Benefit is small as a standalone strategy |
Behavioral intervention | Dose simplification | RCT51,52,53 | - Easy to implement - No additional staff or equipment cost |
Data on oral mesalazine therapy only; uncertain if the result could generalize to other treatment regimens |
Audiovisual reminder system | Meta-analysis of RCT54 | - Easy to implement - Low costs |
It is part of multifaceted intervention so it does not allow isolation of individual methods contributing to the benefit | |
Cognitive behavioral therapy | Problem-solving skill training | RCT55 | Improve adherence and HRQOL in youth with IBD | Small sample size in the RCT limits generalizability |
Multifaceted intervention | Education, behavioral modification, cognitive behavioral therapy, motivational interviewing, telemedicine | RCT56,57,58,59,60,62,63 | Most beneficial in improving adherence | Different sample size, patient population, methods make it difficult to compare among studies; it does not allow isolation of individual methods contributing to the benefit |
RCT, randomized controlled trial; HRQOL, health-related quality of life.