A systematic review and meta-analysis on the effectiveness of education on medication adherence for patients with hypertension, hyperlipidaemia and diabetes

Abstract

Aim: To evaluate the effectiveness of educational interventions in improving medication adherence among adult patients diagnosed with hypertension, hyperlipidaemia and/or diabetes. Design: This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions (PROSPERO registration number: CRD42016053402). Data Sources: A search from seven electronic databases (2003–2016). Review Method: The quality of evidence and strength of the studies was evaluated systematically, followed by an assessment of risks of bias by two reviewers with the Cochrane Collaboration's tool. Results: Eighteen randomized controlled trials demonstrated a low to moderate quality evidence on the improvements of medication adherence with educational interventions. Participants with type 2 diabetes benefited from education interventions but not those with hypertension. No randomized controlled trials (RCT) was found for participants with hyperlipidaemia. Education that was conducted at home showed better medication adherence than education conducted in clinics. Medication adherence was improved after two to three sessions but no significant differences found after three sessions. Conclusion: Through education, health literacy is improved, thus improving medication adherence. Impact: A plethora of educational interventions have been implemented in the clinical settings, but no reviews have hitherto been conducted on their effectiveness. This review suggested that education improves health literacy which is directly proportionate to optimal disease management including medication adherence. The suggestions proposed in this review may impact the individual in terms of their adherence to medication to tackle exacerbation and relapse of chronic diseases and also proposed suggestions for future implementation of an education intervention.