Background This review aimed to (i) identify efficacy of face to face interventions on medication adherence behaviour in adults with Long Term Health Conditions (LTHCs) and (ii) identify Behaviour Change Techniques (BCTs) and study characteristics associated with the efficacy of face to face interventions.
Methods Cochrane Controlled Register of Trials, Embase, MEDLINE (ovid), PsycINFO, Web of science, PubMed, and Scopus databases were searched (from start date till May 2019). Randomized Controlled Trials (RCTs) were included if they described the intervention to improve medication adherence delivered via face to face; included any LTHC, included a comparator group, conducted in any setting and published in English language. Studies were excluded if used additional delivery mode (e.g. leaflet, SMS, apps, follow up phone call related to medication adherence), involved adolescents (<18 years), children, peers, family members and used group format. Two reviewers independently assessed studies for inclusion, appraised risk of bias and extracted data. Pooled effect sizes will be calculated using random/fixed effects model using RevMan 5.3 software.
Results Results from 50 studies were included in the analysis (n=10576). Most face to face interventions took place in secondary care (n=26), included pharmacists in delivery (n=12) and involved counselling (n=10) and behavioural (n=8) approaches on multiple occasions. Majority of the studies were published in years 2014–2019 (n=26) and conducted in the USA (n=16). Most common health condition was HIV (n=10) in comparison to other LTHCs. The first follow up time point (related to medication adherence outcome), will be analysed from all included studies. In terms of risk of bias, most studies were rated as having overall high risk of bias (n=37), followed by some concern due to lack of information (n=12) and low risk of bias (n=1). BCTs were only used in the intervention groups (n=18), in which most commonly used were: ‘self-monitoring behaviour’ and ‘action planning’. The impact of specific individual BCTs and BCTs domains on effectiveness will be examined. Subgroup analyses will be conducted related to age and gender. Results related to the aims of this meta-analysis and meta-regression will be available by the time of the conference.
Conclusion Efficacy of these interventions related to medication adherence outcome and core components of face to face consultations with BCT coding could be very useful to design a cost and time effective face to face very brief or brief interventions related to medication adherence to be implemented in primary care practices in the future.
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