Foley, Louise and Larkin, James and Lombard-Vance, Richard and Murphy, Andrew W and Hynes, Lisa and Galvin, Emer and Molloy, Gerard J (2021) Prevalence and predictors of medication non-adherence among people living with multimorbidity: a systematic review and meta-analysis. BMJ Open, 11 (9). e044987. ISSN 2044-6055

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Abstract

Objectives This systematic review aimed to describe medication non-adherence among people living with multimorbidity according to the current literature, and synthesise predictors of non-adherence in this population. Methods A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. PubMed, EMBASE, CINAHL and PsycINFO were searched for relevant articles published in English language between January 2009 and April 2019. Quantitative studies reporting medication non-adherence and/or predictors of non-adherence among people with two or more chronic conditions were included in the review. A meta-analysis was conducted with a subgroup of studies that used an inclusive definition of multimorbidity to recruit participants, rather than seeking people with specific conditions. Remaining studies reporting prevalence and predictors of non-adherence were narratively synthesised. Results The database search produced 10 998 records and a further 75 were identified through other sources. Following full-text screening, 178 studies were included in the review. The range of reported non-adherence differed by measurement method, at 76.5% for self-report, 69.4% for pharmacy data, and 44.1% for electronic monitoring. A meta-analysis was conducted with eight studies (n=8949) that used an inclusive definition of multimorbidity to recruit participants. The pooled prevalence of non-adherence was 42.6% (95% CI: 34.0 - 51.3%, k=8, I2=97%, p<0.01). The overall range of non-adherence was 7.0%–83.5%. Frequently reported correlates of non-adherence included previous non-adherence and treatment-related beliefs. Conclusions The review identified a heterogeneous literature in terms of conditions studied, and definitions and measures of non-adherence used. Results suggest that future attempts to improve adherence among people with multimorbidity should determine for which conditions individuals require most support. The variable levels of medication non-adherence highlight the need for more attention to be paid by healthcare providers to the impact of multimorbidity on chronic disease self-management.

Item Type:	Article
Keywords:	Multimorbidity; medication non-adherence; chronic disease;
Academic Unit:	Faculty of Science and Engineering > Psychology
Item ID:	18659
Identification Number:	https://doi.org/10.1136/bmjopen-2020-044987
Depositing User:	IR Editor
Date Deposited:	13 Jun 2024 15:03
Journal or Publication Title:	BMJ Open
Publisher:	BMJ Publishing Group LTD
Refereed:	Yes
URI:	Publisher
Use Licence:	This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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