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

18 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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Keywords

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

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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