Evidence map›Paper›PMID 31077247›Full record

SynthesisSystematic reviews2019

Medication adherence influencing factors-an (updated) overview of systematic reviews.

Alina Gast, Tim Mathes

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

Synthesis in Systematic reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 246 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
246citing papers in PubMed, 12 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

246 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Model Development on Adherence to Aspirin in Pregnancy: A Co-Produced Qualitative Systematic Review and Meta-Ethnography.Health expectations : an international journal of public participation in health care and health policy · 2026
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  10. Impact of COVID-19 Pandemic on Adherence to Chronic Therapies: A Systematic Review.International journal of environmental research and public health · 2023
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  14. Association of medication adherence with treatment preferences: incentivizing truthful self-reporting.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
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186 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

2 authors.

Alina GastInstitute for Research in Operative Medicine (Witten/Herdecke University), Ostmerheimer Str. 200, 51109, Cologne, Germany.
Tim MathesInstitute for Health Economics and Clinical Epidemiology of the University of Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany. tim.mathes@uni-wh.de.ORCID 0000-0002-5304-1717

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-adherence negatively affects the efficacy, safety and costs of therapies. Non-adherence is a multifactorial problem. This systematic review (SR) of SRs (overview) aims to identify factors that can influence the adherence of adult patients with chronic physical diseases.

methodsWe performed a systematic literature search in MEDLINE and Embase on June 13, 2018. We included SRs on the factors that can influence adherence in adult patients taking oral medications for treating physical chronic diseases. Two reviewers independently selected studies according to pre-defined inclusion criteria. Two reviewers independently assessed the risk of bias with the ROBIS tool. Data were extracted in standardized tables previously piloted by one reviewer and verified by a second reviewer. We synthesized data in tables in a structured narrative manner.

resultsWe included 21 SRs on eight different conditions. We rated eight SRs to be at low risk of bias and 13 to be at high risk of bias. Although higher education, employment, higher financial status and marriage/partnership mostly showed a positive effect on adherence, the impact was unclear because of the high uncertainty of the underlying evidence. The evidence indicates that socioeconomic status and social support might have a positive impact on adherence and that belonging to an ethnic minority might have a negative impact on adherence. Therapy-related factors (e.g., intake regime) and disease-related factors (e.g., duration) mostly showed no impact on adherence. Analysis of gender showed inconsistent results. Age might have a concave relation to adherence, i.e., adherence is lowest in very young and very old people. Depression has a negative impact on adherence. Impacts of other mental and physical comorbidities were uncertain. Co-payments (any or higher) have a negative impact on adherence. In contrast, the impacts of medication costs and insurance status were uncertain.

conclusionThis overview analyses factors that might impact adherence to oral therapies in adult patients with physical chronic diseases. Our overview suggests that there is a social gradient in adherence. However, for most factors, the evidence was not conclusive due to the risk of bias, inconsistency or imprecision.

Indexed as

Medication AdherenceAge FactorsChronic DiseaseDepressionEthnicityHealth ExpendituresHumansMinority GroupsAdherenceComplianceInfluencing factorsOral medicationOverviewPhysical chronic conditionsSystematic review

Identifiers

PMID31077247
PMCPMC6511120

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.