Patient adherence and medical treatment outcomes: a meta-analysis.

Abstract:

BACKGROUND:Adherence is a factor in the outcome of medical treatment, but the strength and moderators of the adherence-outcome association have not been systematically assessed. OBJECTIVES:A quantitative review using meta-analysis of three decades of empirical research correlating adherence with objective measures of treatment outcomes. METHOD:Sixty-three studies assessing patient adherence and outcomes of medical treatment were found involving medical regimens recommended by a nonpsychiatrist physician, and measuring patient adherence and health outcomes. Studies were analyzed according to disease (acute/chronic, severity), population (adult/child), type of regimen (preventive/treatment, use of medication), and type and sensitivity of adherence and outcomes measurements. RESULTS:Overall, the outcome difference between high and low adherence is 26%. According to a stringent random effects model, adherence is most strongly related to outcomes in studies of nonmedication regimens, where measures of adherence are continuous, and where the disease is chronic (particularly hypertension, hypercholesterolemia, intestinal disease, and sleep apnea). A less stringent fixed effects model shows a trend for higher adherence-outcome correlations in studies of less serious conditions, of pediatric patients, and in those studies using self-reports of adherence, multiple measures of adherence, and less specific measures of outcomes. Intercorrelations among moderator variables in multiple regression show that the best predictor of the adherence-outcome relationship is methodological-the sensitivity/quality of the adherence assessment.

journal_name

Med Care

journal_title

Medical care

authors

DiMatteo MR,Giordani PJ,Lepper HS,Croghan TW

doi

10.1097/00005650-200209000-00009

keywords:

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

794-811

issue

9

eissn

0025-7079

issn

1537-1948

journal_volume

40

pub_type

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