SynthesisBritish journal of clinical pharmacology2026
A systematic review of medication adherence and mortality in chronic disease: Implications for clinical guidelines and policy.
Synthesis in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Content Validation of a Medication Adherence Risk Score (MARS) for Mortality Risk Prediction: A Delphi Consensus.Clinical pharmacology and therapeutics · 2026Pooled it
- A systematic review of medication adherence and mortality in chronic disease: Implications for clinical guidelines and policy.British journal of clinical pharmacology · 2026Pooled it
- Beyond prescriptions: chronic medication adherence predicts mortality risk in a large-scale cohort study.Frontiers in pharmacology · 2025Article
- A pilot programme of community volunteers to improve hepatitis B medication adherence, Kiribati, 2025.Western Pacific surveillance and response journal : WPSARArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis systematic review aims to investigate whether good medication adherence in adults with chronic conditions is associated with a lower mortality risk compared to poor adherence within published literature, and the extent to which this relationship is represented within South African policy and legislation.
methodsA systematic search of three electronic databases-PubMed, MEDLINE (Ovid) and Scopus-was conducted. Only primary research articles published in English after March 2004 and with study populations >18 years of age were considered. South African health legislation and professional guidelines from 2014 onwards were sourced using search terms aligned with the systematic review strategy and systematically analysed.
resultsTwenty-six articles were included in the systematic review. Effect measures included hazard ratios (HR), incidence rate ratios (IRRs) and odds ratios (OR), where values greater than 1 indicate a higher risk of mortality. The effect measures from individual studies were categorized according to adherence levels: good, intermediate, poor and non-adherent. A total of 17 effect measures were reported for good adherence, only one of which was greater than 1. There were 44 effect measures reported for intermediate, poor and non-adherence categories, all of which were greater than 1. Pooled estimates for poor adherence and non-adherence had the highest HRs (HR = 1.63; 95% confidence interval [CI]: 1.36-1.96 and HR = 2.77; 95% CI: 2.3-3.34 respectively). Review of South African health legislation and professional guidelines showed a dominance of mortality-related terms (1.323 and 2.98 matches per 1000 words for 'mortality' and 'death', respectively) compared with adherence-related terms (0.053-2.98 matches per 1000 words). Co-occurrence between medication adherence-related search terms (MARS, adherence, medication adherence, adhere, non-adherence and medication compliance) and mortality-related search terms (death, mortality and survival) was low within all documents analysed.
conclusionThe systematic review demonstrates a clear relationship between good adherence to chronic medication and a lower mortality risk. However, the review of legislative and policy documents suggests that government efforts are focused primarily on surveillance, rather than strategy or preventative measures. This strong evidence should motivate incorporating adherence-based risk assessments into clinical and legal frameworks.
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