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Interventions led by healthcare providers are effective in supporting medication adherence following acute coronary syndrome

Crawshaw J, Auyeung V, Ashworth L, Norton S, Weinman J.  Healthcare provider-led interventions to support medication adherence following ACS: A meta-analysis Open Heart. 2017;4(2).

Review question

  • Are interventions led by healthcare providers effective in supporting medication adherence in patients with acute coronary syndrome?

Background

  • Acute coronary syndrome refers to a range of conditions associated with sudden, reduced blood flow to the heart (for example, heart attack and unstable angina).
  • When patients do not take their medication as prescribed (also called ‘medication adherence’) after an acute coronary syndrome, it greatly increases their risk of rehospitalization and death.
  • Healthcare providers working with patients by providing reminders, information and psychological support may be a promising solution to improve medication adherence.
  • However, there is little research describing the impact of healthcare providers’ support on medication adherence specifically among patients with acute coronary syndrome.

How the review was done

  • A detailed search of a number of electronic databases was conducted to identify studies published up to 2017. Studies on healthcare providers providing support to improve medication adherence among patients with acute coronary syndrome were included in the systematic review.
  • A total of 6,072 studies were identified in searches, and 27 were included in the review after assessing their eligibility.
  • This review was partly funded by King’s College London and the University of California.

What the researchers found

  • The review concluded that some interventions led by healthcare providers can make a small positive impact on medication adherence in patients with acute coronary syndrome.
  • Providing written, verbal or visual information about the consequences of medication adherence was the most frequently used intervention. However, while providing information is necessary to improve patients’ knowledge, it is not sufficient as a stand-alone strategy to improve medication adherence.
  • The researchers found that nurses were better than pharmacists at interacting with acute coronary syndrome patients. Results should be interpreted with caution due to limited research regarding studies examining pharmacist-led interventions.

Conclusion

  • Healthcare provider-led interventions can make a small positive impact on medication adherence in patients with acute coronary syndrome, with telephone reminders being more effective than in-person reminders.
  • Nurses were better than pharmacists at interacting with acute coronary syndrome patients, however research examining pharmacist-led interventions is limited.



Glossary

Acute coronary syndrome
A condition, such as a heart attack or chest pain, caused by a sudden reduction of blood flow to the heart.
Angina
Chest pain due to reduced blood flow to the heart.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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