Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes

Systematic Review and Meta-Analysis

Hervé Tchala Vignon Zomahoun, Marijn de Bruin, Laurence Guillaumie, Jocelyne Moisan, Jean Pierre Grégoire, Norma Pérez, Lydi Anne Vézina-Im, Line Guénette*

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Citations (Scopus)
38 Downloads (Pure)

Abstract

Objectives: To estimate the pooled effect size of oral antidiabetic drug (OAD) adherence-enhancing interventions and to explore which of the behavior change techniques (BCTs) applied in the intervention groups modified this pooled intervention effect size. Methods: We searched relevant studies published until September 3, 2013, on MEDLINE, Embase, PsycInfo, the Cochrane Library, CINAHL, Current Contents Connect, and Web of Science. Selected studies were qualitatively synthesized, and those of at least medium quality were included in the meta-analysis. A random-effects model was used to pool effectiveness (Hedges's g) and to examine heterogeneity (Higgins I <sup>2</sup>). We also explored the influence on the pooled effectiveness of unique intervention BCTs (those delivered to the intervention groups but not control groups in a trial) by estimating their modifying effects. Results: Fourteen studies were selected for the qualitative synthesis and 10 were included in the meta-analysis. The pooled effectiveness of the interventions was 0.21 (95% confidence interval -0.05 to 0.47; I <sup>2</sup> = 82%). Eight unique BCTs were analyzed. "Cope with side effects" (P = 0.003) and "general intention formation" (P = 0.006) had a modifying effect on the pooled effectiveness. The pooled effectiveness of the interventions in which "cope with side effects" was applied was moderate (0.64; 95% confidence interval 0.31-0.96; I <sup>2</sup> = 56%). Conclusions: The overall effectiveness of OAD adherence-enhancing interventions that have been tested is small. Helping patients cope with side effects or formulate desired treatment outcomes could have an impact on the effectiveness of OAD adherence-enhancing interventions. Only those interventions that include helping patients to cope with side effects appear to be particularly effective in improving OAD adherence.

Original languageEnglish
Article number1159
Pages (from-to)530-540
Number of pages11
JournalValue in Health
Volume18
Issue number4
Early online date23 May 2015
DOIs
Publication statusPublished - Jun 2015

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Hypoglycemic Agents
Type 2 Diabetes Mellitus
Meta-Analysis
Confidence Intervals
MEDLINE
Libraries
Control Groups

Keywords

  • Adherence
  • Diabetes
  • Intervention
  • Meta-analysis
  • Oral antidiabetic drug

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes : Systematic Review and Meta-Analysis. / Vignon Zomahoun, Hervé Tchala; de Bruin, Marijn; Guillaumie, Laurence; Moisan, Jocelyne; Grégoire, Jean Pierre; Pérez, Norma; Vézina-Im, Lydi Anne; Guénette, Line.

In: Value in Health, Vol. 18, No. 4, 1159, 06.2015, p. 530-540.

Research output: Contribution to journalArticle

Vignon Zomahoun, Hervé Tchala ; de Bruin, Marijn ; Guillaumie, Laurence ; Moisan, Jocelyne ; Grégoire, Jean Pierre ; Pérez, Norma ; Vézina-Im, Lydi Anne ; Guénette, Line. / Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes : Systematic Review and Meta-Analysis. In: Value in Health. 2015 ; Vol. 18, No. 4. pp. 530-540.
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note = "We thank Frederic Bergeron, information scientist, for assistance in search strategies. We thank American Journal Experts for editing the text. Source of financial support: This study was funded by the Laval University Chair on Adherence to Treatments. This Chair is supported by nonrestricted grants from AstraZeneca Canada, Merck Canada, Sanofi Canada, and Pfizer Canada and from the Prends soin de toi program (a Quebec provincial program for the improvement of public health).",
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T1 - Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes

T2 - Systematic Review and Meta-Analysis

AU - Vignon Zomahoun, Hervé Tchala

AU - de Bruin, Marijn

AU - Guillaumie, Laurence

AU - Moisan, Jocelyne

AU - Grégoire, Jean Pierre

AU - Pérez, Norma

AU - Vézina-Im, Lydi Anne

AU - Guénette, Line

N1 - We thank Frederic Bergeron, information scientist, for assistance in search strategies. We thank American Journal Experts for editing the text. Source of financial support: This study was funded by the Laval University Chair on Adherence to Treatments. This Chair is supported by nonrestricted grants from AstraZeneca Canada, Merck Canada, Sanofi Canada, and Pfizer Canada and from the Prends soin de toi program (a Quebec provincial program for the improvement of public health).

PY - 2015/6

Y1 - 2015/6

N2 - Objectives: To estimate the pooled effect size of oral antidiabetic drug (OAD) adherence-enhancing interventions and to explore which of the behavior change techniques (BCTs) applied in the intervention groups modified this pooled intervention effect size. Methods: We searched relevant studies published until September 3, 2013, on MEDLINE, Embase, PsycInfo, the Cochrane Library, CINAHL, Current Contents Connect, and Web of Science. Selected studies were qualitatively synthesized, and those of at least medium quality were included in the meta-analysis. A random-effects model was used to pool effectiveness (Hedges's g) and to examine heterogeneity (Higgins I 2). We also explored the influence on the pooled effectiveness of unique intervention BCTs (those delivered to the intervention groups but not control groups in a trial) by estimating their modifying effects. Results: Fourteen studies were selected for the qualitative synthesis and 10 were included in the meta-analysis. The pooled effectiveness of the interventions was 0.21 (95% confidence interval -0.05 to 0.47; I 2 = 82%). Eight unique BCTs were analyzed. "Cope with side effects" (P = 0.003) and "general intention formation" (P = 0.006) had a modifying effect on the pooled effectiveness. The pooled effectiveness of the interventions in which "cope with side effects" was applied was moderate (0.64; 95% confidence interval 0.31-0.96; I 2 = 56%). Conclusions: The overall effectiveness of OAD adherence-enhancing interventions that have been tested is small. Helping patients cope with side effects or formulate desired treatment outcomes could have an impact on the effectiveness of OAD adherence-enhancing interventions. Only those interventions that include helping patients to cope with side effects appear to be particularly effective in improving OAD adherence.

AB - Objectives: To estimate the pooled effect size of oral antidiabetic drug (OAD) adherence-enhancing interventions and to explore which of the behavior change techniques (BCTs) applied in the intervention groups modified this pooled intervention effect size. Methods: We searched relevant studies published until September 3, 2013, on MEDLINE, Embase, PsycInfo, the Cochrane Library, CINAHL, Current Contents Connect, and Web of Science. Selected studies were qualitatively synthesized, and those of at least medium quality were included in the meta-analysis. A random-effects model was used to pool effectiveness (Hedges's g) and to examine heterogeneity (Higgins I 2). We also explored the influence on the pooled effectiveness of unique intervention BCTs (those delivered to the intervention groups but not control groups in a trial) by estimating their modifying effects. Results: Fourteen studies were selected for the qualitative synthesis and 10 were included in the meta-analysis. The pooled effectiveness of the interventions was 0.21 (95% confidence interval -0.05 to 0.47; I 2 = 82%). Eight unique BCTs were analyzed. "Cope with side effects" (P = 0.003) and "general intention formation" (P = 0.006) had a modifying effect on the pooled effectiveness. The pooled effectiveness of the interventions in which "cope with side effects" was applied was moderate (0.64; 95% confidence interval 0.31-0.96; I 2 = 56%). Conclusions: The overall effectiveness of OAD adherence-enhancing interventions that have been tested is small. Helping patients cope with side effects or formulate desired treatment outcomes could have an impact on the effectiveness of OAD adherence-enhancing interventions. Only those interventions that include helping patients to cope with side effects appear to be particularly effective in improving OAD adherence.

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KW - Intervention

KW - Meta-analysis

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