Evidence map›Paper›PMID 29850883›Full record

ReviewJournal of public health (Oxford, England)2019

Adherence to cardiovascular medication: a review of systematic reviews.

K H Leslie, C McCowan, J P Pell

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of public health (Oxford, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 3 pooled it
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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

50 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

3 authors.

K H LeslieInstitute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, UK.
C McCowanRobertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Boyd Orr Building, Glasgow, UK.
J P PellInstitute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUse of cardiovascular medication has increased over time, especially for primary and secondary prevention, with polypharmacy common.

methodsReview of published systematic reviews of the factors and outcomes associated with adherence to cardiovascular medication using MEDLINE, Embase, CINAHL and PsycINFO databases. Quality was assessed using the AMSTAR tool.

resultsOf 789 systematic reviews identified, 45 met the inclusion criteria and passed the quality assessment; 34 focused on factors associated with adherence, and 11 on outcomes. High heterogeneity, both between and within reviews, precluded meta-analysis and so a pooled estimate of adherence levels could not be derived. Adherence was associated with disease factors, therapy factors, healthcare factors, patient factors and social factors, though with some inconsistencies. In total, 91% of reviews addressing outcomes reported that low adherence was associated with poorer clinical and economic endpoints.

conclusionsFactors from across five key domains relate to non-adherence to cardiovascular medications, and may contribute to poorer clinical outcomes. Interventions to improve adherence should be developed to address modifiable factors and targeted at those at highest risk of non-adherence. Adherence research is highly heterogeneous to-date and efforts to standardize this should be implemented to improve comparability.

Indexed as

Medication AdherenceCardiovascular AgentsCardiovascular DiseasesFemaleHumansMalePolypharmacySocioeconomic FactorsTreatment OutcomeCardiovascular Agentsbehaviourcirculatory diseasesystematic review

Identifiers

PMID29850883
PMCPMC6459362

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Registered trials

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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.