Evidence map›Paper›PMID 31486099›Full record

SynthesisBritish journal of clinical pharmacology2019

The association between medication non-adherence and adverse health outcomes in ageing populations: A systematic review and meta-analysis.

Caroline A Walsh, Caitriona Cahir, Sarah Tecklenborg, Catherine Byrne, Michael A Culbertson, Kathleen E Bennett

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 8 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

147 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  17. Community Health Workers' and Pharmacists' Perspectives of a CHW-Pharmacist Collaboration Model to Support Medication Adherence.Health expectations : an international journal of public participation in health care and health policy · 2026
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87 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

6 authors.

Caroline A WalshDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID 0000-0001-9749-5916
Caitriona CahirDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID 0000-0002-7137-5737
Sarah TecklenborgDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
Catherine ByrneDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID 0000-0003-3306-6375
Michael A CulbertsonSchool of Psychology, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
Kathleen E BennettDivision of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID 0000-0002-2861-7665

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this systematic review and meta-analysis was to synthesise the evidence relating to medication non-adherence and its association with health outcomes in people aged ≥50 years.

methodsSeven databases were searched up to February 2019 for observational studies that measured medication (non-)adherence as a predictor of the following health outcomes in adults aged ≥50 years: healthcare utilisation (hospitalisation, emergency department visits, outpatient visits and general practitioner visits), mortality, adverse clinical events and quality of life. Screening and quality assessment using validated criteria were completed by 2 reviewers independently. Random effects models were used to generate pooled estimates of association using adjusted study results. The full methodological approach was published on PROSPERO (ID: CRD42017077264).

resultsSixty-six studies were identified for qualitative synthesis, with 11 of these studies eligible for meta-analyses. A meta-analysis including 3 studies measuring medication non-adherence in adults aged ≥55 years showed a significant association with all-cause hospitalisation (adjusted odds ratio 1.17, 95% confidence interval [CI] 1.12, 1.21). A meta-analysis including 2 studies showed that medication non-adherence was not significantly associated with an emergency department visit (adjusted odds ratio 1.05, 95% CI 0.90, 1.22). Good adherence was associated with a 21% reduction in long-term mortality risk in comparison to medication non-adherence (adjusted hazard ratio 0.79, 95% CI 0.63, 0.98).

conclusionMedication non-adherence may be significantly associated with all-cause hospitalisation and mortality in older people. Medication adherence should be monitored and addressed in this cohort to minimise hospitalisation, improve clinical outcomes and reduce healthcare costs.

Indexed as

Drug MonitoringMultimorbidityQuality of LifeAgedAged, 80 and overAge FactorsEmergency Service, HospitalHealth Care CostsHospitalizationHumansMiddle AgedMortalityObservational Studies as TopicOffice VisitsPatient Acceptance of Health Careageing populationhospitalisationmedication adherencemortality

Identifiers

PMID31486099
PMCPMC6848955

What OpenQuestion holds

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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.