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Adherence to cardiovascular medications in the South Asian population:A systematic review of current evidence and future directions

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World Journal of Cardiology 2015年第12期7卷 938-947页

作者： Julia M Akeroyd Winston J Chan Ayeesha K Kamal latha palaniappan Salim S Virani the Health Policy Quality and Informatics ProgramMichael E De Bakey Veterans Affairs Medical CenterHealth Services Research and Development Center for Innovations Section of Neurology Department of MedicineAga Khan University Hospital General Medicine Disciplines Stanford School of Medicine Health Services Research and Development Michael E DeB akey Veterans Affairs Medical Center Section of Cardiovascular Research Department of MedicineBaylor College of Medicine Center for Cardiovascular Disease Prevention Methodist De Bakey Heart and Vascular Center

AIM: To review methods of assessing adherence and strategies to improve adherence to cardiovascular disease(CVD) medications,among South Asian CVD patients. METHODS: We conducted a systematic review of English language studies that examined CVD medication adherence in South Asian populations from 1966 to April 1,2015 in SCOPUS and Pub Med. Working in duplicate,we identified 61 studies. After exclusions,26 studies were selected for full text review. Of these,17 studies were included in the final review. We abstracted data on several factors including study design,study population,method of assessing adherence and adherence rate. RESULTS: These studies were conducted in India(n = 11),Pakistan(n = 3),Bangladesh(n = 1),Nepal(n = 1) and Sri Lanka(n = 1). Adherence rates ranged from 32%-95% across studies. Of the 17 total publications included,10 focused on assessing adherence to CVD medications and 7 focused on assessing the impact of interventions on medication adherence. The validated Morisky Medication Adherence Scale(MMAS) was used as the primary method of assessing adherence in five studies. Three studies used validated questionnaires similar to the MMAS,and one study utilized Medication Event Monitoring System caps,with the remainder of the studies utilizing pill count and self-report measures. As expected,studies using non-validated self-report measures described higher rates of adherence than studies using validated scale measurements and pill count. The included intervention studies examined the use of polypill therapy,provider education and patient counseling to improve medication adherence. CONCLUSION: The overall medication adherence rates were low in the region,which suggest a growing need for future interventions to improve adherence.

关键词： Assessing medication adherence South Asia Cardiovascular disease medication

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