Evidence map›Paper›PMID 20464522›Full record

SynthesisJournal of general internal medicine2010

Physician effectiveness in interventions to improve cardiovascular medication adherence: a systematic review.

Sarah L Cutrona, Niteesh K Choudhry, Margaret Stedman, Amber Servi, Joshua N Liberman, Troyen Brennan, Michael A Fischer, M Alan Brookhart, William H Shrank

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of general internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  13. Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland.Medical science monitor : international medical journal of experimental and clinical research · 2023
    Review
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  18. Patient engagement: an investigation at a primary care clinic.International journal of general medicine · 2013
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Sarah L CutronaDivision of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA 02120, USA. slcutrona@gmail.com
Niteesh K Choudhry
Margaret Stedman
Amber Servi
Joshua N Liberman
Troyen Brennan
Michael A Fischer
M Alan Brookhart
William H Shrank

Funding

Hierarchical models of prescription drug use in the elderlyK25AG027400 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BROOKHART, MAURICE ALAN · 2006 to 2010
$653k
An intervention to improve rational prescribing in cardiovascular diseaseK23HL090505 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SHRANK, WILLIAM · 2007 to 2010
$650k
NHLBI NIH HHS HL-090505NHLBI NIH HHS K23 HL090505NIA NIH HHS AG-027400NIA NIH HHS K25 AG027400
6 · The paper itself

Abstract

backgroundMedications for the prevention and treatment of cardiovascular disease save lives but adherence is often inadequate. The optimal role for physicians in improving adherence remains unclear.

objectiveUsing existing evidence, we set the goal of evaluating the physician's role in improving medication adherence.

designWe conducted systematic searches of English-language peer-reviewed publications in MEDLINE and EMBASE from 1966 through 12/31/2008. SUBJECTS AND

interventionsWe selected randomized controlled trials of interventions to improve adherence to medications used for preventing or treating cardiovascular disease or diabetes. MAIN MEASURES: Articles were classified as either (1) physician "active"-a physician participated in designing or implementing the intervention; (2) physician "passive"-physicians treating intervention group patients received patient adherence information while physicians treating controls did not; or (3) physicians noninvolved. We also identified studies in which healthcare professionals helped deliver the intervention. We did a meta-analysis of the studies involving healthcare professionals to determine aggregate Cohen's D effect sizes (ES). KEY

resultsWe identified 6,550 articles; 168 were reviewed in full, 82 met inclusion criteria. The majority of all studies (88.9%) showed improved adherence. Physician noninvolved studies were more likely (35.0% of studies) to show a medium or large effect on adherence compared to physician-involved studies (31.3%). Among interventions requiring a healthcare professional, physician-noninvolved interventions were more effective (ES 0.47; 95% CI 0.38-0.56) than physician-involved interventions (ES 0.25; 95% CI 0.21-0.29; p < 0.001). Among physician-involved interventions, physician-passive interventions were marginally more effective (ES 0.29; 95% CI 0.22-0.36) than physician-active interventions (ES 0.23; 95% CI 0.17-0.28; p = 0.2).

conclusionsAdherence interventions utilizing non-physician healthcare professionals are effective in improving cardiovascular medication adherence, but further study is needed to identify the optimal role for physicians.

Indexed as

Medication AdherencePhysician's RoleCardiovascular AgentsCardiovascular DiseasesHealth PersonnelHumansRandomized Controlled Trials as TopicCardiovascular Agents

Identifiers

PMID20464522
PMCPMC2955481

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.