Effectiveness of interventions to improve medication adherence in adults with depressive disorders : a meta-analysis
González de León, Beatriz (Unidad Docente Multiprofesional de Atención Familiar y Comunitaria "La Laguna - Tenerife Norte" (Santa Cruz de Tenerife, Illes Canàries))
del Pino-Sedeño, Tasmania (Servicio Canario de la Salud)
Serrano-Pérez, Pedro (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodríguez Álvarez, Cristobalina (Universidad de La Laguna)
Bejarano-Quisoboni, Daniel (Red de Investigación en Servicios de Salud en Enfermedades Crónicas (Madrid))
Trujillo-Martín, María M. (Red de Investigación en Servicios de Salud en Enfermedades Crónicas (Madrid))
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Non-adherence to medication is a major obstacle in the treatment of depressive disorders. We systematically reviewed the literature to evaluate the effectiveness of interventions aimed at improving adherence to medication among adults with depressive disorders with emphasis on initiation and implementation phase. We searched Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index and Science Citation Index for randomized or non-randomized controlled trials up to January 2022. Risk of bias was assessed using the criteria of the Cochrane Collaboration. Meta-analyses, cumulative and meta-regression analyses for adherence were conducted. Forty-six trials (n = 24,324) were included. Pooled estimate indicates an increase in the probability of adherence to antidepressants at 6 months with the different types of interventions (OR 1. 33; 95% CI: 1. 09 to 1. 62). The improvement in adherence is obtained from 3 months (OR 1. 62, 95% CI: 1. 25 to 2. 10) but it is attenuated at 12 months (OR 1. 25, 95% CI: 1. 02 to 1. 53). Selected articles show methodological differences, mainly the diversity of both the severity of the depressive disorder and intervention procedures. In the samples of these studies, patients with depression and anxiety seem to benefit most from intervention (OR 2. 77, 95% CI: 1. 74 to 4. 42) and collaborative care is the most effective intervention to improve adherence (OR 1. 88, 95% CI: 1. 40 to 2. 54). Our findings indicate that interventions aimed at improving adherence to medication among adults with depressive disorders are effective up to six months. However, the evidence on the effectiveness of long-term adherence is insufficient and supports the need for further research efforts. International Prospective Register for Systematic Reviews (PROSPERO) number: . The online version contains supplementary material available at 10. 1186/s12888-022-04120-w.
Grants:	Instituto de Salud Carlos III PI18/00767
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Major Depressive Disorder ; Meta-analysis ; Systematic review ; Treatment Adherence
Published in:	BMC Psychiatry, Vol. 22 (july 2022) , ISSN 1471-244X

DOI: 10.1186/s12888-022-04120-w
PMID: 35858887

21 p, 1.9 MB

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