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Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis
OBJECTIVES: Patient adherence and persistence is important to improve outcomes in chronic conditions, including inflammatory and immunologic (I&I) diseases. Patient programs that aim at improving medication adherence or persistence play an essential role in optimizing care. This meta-analysis as...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364594/ https://www.ncbi.nlm.nih.gov/pubmed/25792817 http://dx.doi.org/10.2147/PPA.S77053 |
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author | Burudpakdee, Chakkarin Khan, Zeba M Gala, Smeet Nanavaty, Merena Kaura, Satyin |
author_facet | Burudpakdee, Chakkarin Khan, Zeba M Gala, Smeet Nanavaty, Merena Kaura, Satyin |
author_sort | Burudpakdee, Chakkarin |
collection | PubMed |
description | OBJECTIVES: Patient adherence and persistence is important to improve outcomes in chronic conditions, including inflammatory and immunologic (I&I) diseases. Patient programs that aim at improving medication adherence or persistence play an essential role in optimizing care. This meta-analysis assessed the effectiveness of patient programs in the therapeutic area of I&I diseases. METHODS: A global systematic literature review was conducted with inclusion criteria of: patient programs in I&I diseases; published in English language between January 2008 and September 2013; and reporting measures of adherence or persistence, including medication possession ratio >80% and persistence rate. A meta-analysis was performed using a random effects model. Subgroup analyses based on the type of program was performed whenever feasible. RESULTS: Of 67 studies reviewed for eligibility, a total of 17 studies qualified for inclusion in the meta-analysis. Overall, patient programs increased adherence (odds ratio [OR]=2.48, 95% confidence interval [CI]=1.68–3.64, P<0.00001) as compared with standard of care. Combination patient programs that used both informational and behavioral strategies were superior in improving adherence (OR=3.68, 95% CI=2.20–6.16, P<0.00001) compared with programs that used only informational (OR=2.16, 95% CI=1.36–3.44, P=0.001) or only behavioral approaches (OR=1.85, 95% CI=1.00–3.45, P=0.05). Additionally, patients were more likely to be persistent (OR=2.26, 95% CI=1.16–4.39, P=0.02) in the intervention group as compared with the control group. Persistence (in days) was significantly (P=0.007) longer, by 42 additional days, in the intervention group than in the control group. CONCLUSIONS: Patient programs can significantly improve adherence as well as persistence in the therapeutic area of I&I diseases. Programs employing a multimodal approach are more effective in improving adherence than programs with informational or behavioral strategies alone. This in turn may improve patient outcomes. |
format | Online Article Text |
id | pubmed-4364594 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-43645942015-03-19 Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis Burudpakdee, Chakkarin Khan, Zeba M Gala, Smeet Nanavaty, Merena Kaura, Satyin Patient Prefer Adherence Original Research OBJECTIVES: Patient adherence and persistence is important to improve outcomes in chronic conditions, including inflammatory and immunologic (I&I) diseases. Patient programs that aim at improving medication adherence or persistence play an essential role in optimizing care. This meta-analysis assessed the effectiveness of patient programs in the therapeutic area of I&I diseases. METHODS: A global systematic literature review was conducted with inclusion criteria of: patient programs in I&I diseases; published in English language between January 2008 and September 2013; and reporting measures of adherence or persistence, including medication possession ratio >80% and persistence rate. A meta-analysis was performed using a random effects model. Subgroup analyses based on the type of program was performed whenever feasible. RESULTS: Of 67 studies reviewed for eligibility, a total of 17 studies qualified for inclusion in the meta-analysis. Overall, patient programs increased adherence (odds ratio [OR]=2.48, 95% confidence interval [CI]=1.68–3.64, P<0.00001) as compared with standard of care. Combination patient programs that used both informational and behavioral strategies were superior in improving adherence (OR=3.68, 95% CI=2.20–6.16, P<0.00001) compared with programs that used only informational (OR=2.16, 95% CI=1.36–3.44, P=0.001) or only behavioral approaches (OR=1.85, 95% CI=1.00–3.45, P=0.05). Additionally, patients were more likely to be persistent (OR=2.26, 95% CI=1.16–4.39, P=0.02) in the intervention group as compared with the control group. Persistence (in days) was significantly (P=0.007) longer, by 42 additional days, in the intervention group than in the control group. CONCLUSIONS: Patient programs can significantly improve adherence as well as persistence in the therapeutic area of I&I diseases. Programs employing a multimodal approach are more effective in improving adherence than programs with informational or behavioral strategies alone. This in turn may improve patient outcomes. Dove Medical Press 2015-03-11 /pmc/articles/PMC4364594/ /pubmed/25792817 http://dx.doi.org/10.2147/PPA.S77053 Text en © 2015 Burudpakdee et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Burudpakdee, Chakkarin Khan, Zeba M Gala, Smeet Nanavaty, Merena Kaura, Satyin Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title | Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title_full | Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title_fullStr | Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title_full_unstemmed | Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title_short | Impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
title_sort | impact of patient programs on adherence and persistence in inflammatory and immunologic diseases: a meta-analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364594/ https://www.ncbi.nlm.nih.gov/pubmed/25792817 http://dx.doi.org/10.2147/PPA.S77053 |
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