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Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis
Background: Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. Purpose: This study evaluates the effective...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044982/ https://www.ncbi.nlm.nih.gov/pubmed/36975271 http://dx.doi.org/10.3390/bs13030246 |
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author | Choi, Yan Yee Cherizza Fineberg, Micah Kassavou, Aikaterini |
author_facet | Choi, Yan Yee Cherizza Fineberg, Micah Kassavou, Aikaterini |
author_sort | Choi, Yan Yee Cherizza |
collection | PubMed |
description | Background: Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. Purpose: This study evaluates the effectiveness of remote interventions and their mechanisms of action in supporting medication adherence after stroke. Methods: PubMed, MEDLINE via Ovid, Cochrane CENTRAL, the Web of Science, SCOPUS, and PsycINFO were searched, and meta-analysis was performed using the Review Manager Tool. Intervention content analysis was conducted based on the COM-B model. Results: Ten eligible studies were included in the review and meta-analysis. The evidence suggested that patients who received remote interventions had significantly better medication adherence (SMD 0.49, 95% CI [0.04, 0.93], and p = 0.03) compared to those who received the usual care. The adherence ratio also indicated the interventions’ effectiveness (odds ratio 1.30, 95% CI [0.55, 3.10], and p = 0.55). The systolic and diastolic blood pressure (MD −3.73 and 95% CI [−5.35, −2.10])/(MD −2.16 and 95% CI [−3.09, −1.22]) and cholesterol levels (MD −0.36 and 95% CI [−0.52, −0.20]) were significantly improved in the intervention group compared to the control. Further behavioural analysis demonstrated that enhancing the capability within the COM-B model had the largest impact in supporting improvements in adherence behaviour and relevant clinical outcomes. Patients’ satisfaction and the interventions’ usability were both high, suggesting the interventions’ acceptability. Conclusion: Telemedicine and mHealth interventions are effective in improving medication adherence and clinical indicators in stroke patients. Future studies could usefully investigate the effectiveness and cost-effectiveness of theory-based and remotely delivered interventions as an adjunct to stroke rehabilitation programmers. |
format | Online Article Text |
id | pubmed-10044982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100449822023-03-29 Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis Choi, Yan Yee Cherizza Fineberg, Micah Kassavou, Aikaterini Behav Sci (Basel) Review Background: Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. Purpose: This study evaluates the effectiveness of remote interventions and their mechanisms of action in supporting medication adherence after stroke. Methods: PubMed, MEDLINE via Ovid, Cochrane CENTRAL, the Web of Science, SCOPUS, and PsycINFO were searched, and meta-analysis was performed using the Review Manager Tool. Intervention content analysis was conducted based on the COM-B model. Results: Ten eligible studies were included in the review and meta-analysis. The evidence suggested that patients who received remote interventions had significantly better medication adherence (SMD 0.49, 95% CI [0.04, 0.93], and p = 0.03) compared to those who received the usual care. The adherence ratio also indicated the interventions’ effectiveness (odds ratio 1.30, 95% CI [0.55, 3.10], and p = 0.55). The systolic and diastolic blood pressure (MD −3.73 and 95% CI [−5.35, −2.10])/(MD −2.16 and 95% CI [−3.09, −1.22]) and cholesterol levels (MD −0.36 and 95% CI [−0.52, −0.20]) were significantly improved in the intervention group compared to the control. Further behavioural analysis demonstrated that enhancing the capability within the COM-B model had the largest impact in supporting improvements in adherence behaviour and relevant clinical outcomes. Patients’ satisfaction and the interventions’ usability were both high, suggesting the interventions’ acceptability. Conclusion: Telemedicine and mHealth interventions are effective in improving medication adherence and clinical indicators in stroke patients. Future studies could usefully investigate the effectiveness and cost-effectiveness of theory-based and remotely delivered interventions as an adjunct to stroke rehabilitation programmers. MDPI 2023-03-11 /pmc/articles/PMC10044982/ /pubmed/36975271 http://dx.doi.org/10.3390/bs13030246 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Choi, Yan Yee Cherizza Fineberg, Micah Kassavou, Aikaterini Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title_full | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title_fullStr | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title_full_unstemmed | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title_short | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
title_sort | effectiveness of remote interventions to improve medication adherence in patients after stroke: a systematic literature review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044982/ https://www.ncbi.nlm.nih.gov/pubmed/36975271 http://dx.doi.org/10.3390/bs13030246 |
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