Evidence map›Paper›PMID 29765208›Full record

ReviewPatient preference and adherence2018

Primary nonadherence to chronic disease medications: a meta-analysis.

Mark Lemstra, Chijioke Nwankwo, Yelena Bird, John Moraros

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Patient preference and adherence, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 7 pooled it
30.5field-weighted citation impact, top 1% of its field
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

75 citing papers in PubMed, 7 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Pooled it
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  7. Economic Evaluations Informed Exclusively by Real World Data: A Systematic Review.International journal of environmental research and public health · 2020
    Pooled it
  8. Trial
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    Review
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  12. Adherence to oral thromboprophylaxis in atrial fibrillation: an overview for clinicians.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Review
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  18. Non-dispensed prescriptions - A nationwide descriptive study.Exploratory research in clinical and social pharmacy · 2024
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  20. Article

15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Mark LemstraAlliance Health Medical Clinics, Moose Jaw, Regina and Saskatoon, Saskatchewan, Canada.
Chijioke NwankwoSchool of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Yelena BirdSchool of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
John MorarosSchool of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
University of Saskatchewan · CADigital Research Alliance of Canada

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedication nonadherence is a global problem that requires urgent attention. Primary nonadherence occurs when a patient consults with a medical doctor, receives a referral for medical therapy but never fills the first dispensation for the prescription medication. Nonadherence to chronic disease medications costs the USA ~$290 billion (USD) every year in avoidable health care costs. In Canada, it is estimated that 5.4% of all hospitalizations are due to medication nonadherence.

objectivesThe objective of this study was to quantify the extent of primary nonadherence for four of the most common chronic disease medications. The second objective was to identify factors associated with primary nonadherence to chronic disease medications. MATERIALS AND

methodsWe conducted an extensive systematic literature review of eight databases with a wide range of keywords. We identified relevant articles for primary nonadherence to antihypertensives, lipid-lowering agents, hypoglycemics, and antidepressants. After further screening and assessment of methodologic quality, relevant data were extracted and analyzed using a random-effects model.

resultsTwenty-four articles were included for our meta-analysis after full review and assessment for risk of bias. The pooled primary nonadherence rate for the four chronic disease medications was 14.6% (95% CI: 13.1%-16.2%). Primary medication nonadherence was higher for lipid-lowering medications among the four chronic disease medications assessed (20.8%; 95% CI: 16.0%-25.6%). The rates in North America (17.0%; 95% CI: 14.4%-19.5%) were twice those from Europe (8.5%; 95% CI: 7.1%-9.9%). The absence of social support (20%; 95% CI: 14.4%-26.6%) was the most common sociodemographic variable associated with chronic disease medication primary nonadherence.

conclusionEvidence suggests that a considerable percentage of patients do not initially fill their medications for treatable chronic diseases or conditions. This represents a major health care problem that can be successfully addressed. Efforts should be directed toward proper medication counseling, patient social support, and clinical follow-up, especially when the indications for the prescribed medication aim to provide primary prevention.

Indexed as

chronic disease medicationinitial nonadherencepredictors of primary nonadherenceprescribed medicationsprimary nonadherence

Identifiers

PMID29765208
PMCPMC5944464
OpenAlexW2802601893

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.