Community pharmacist interventions to improve adherence to lipid lowering medication and their influence on clinical outcomes: A systematic review and <scp>meta‐analysis</scp>
Ainhoa Oñatibia‐Astibia, Amaia Malet‐Larrea, Miguel Ángel Gastelurrutia, Begoña Calvo, Estíbaliz Goyenechea
Abstract
Abstract Introduction Non‐adherence is a major problem among patients with chronic diseases. Community pharmacists are ideally positioned to detect non‐adherence and to provide patient‐centred interventions. Objective To conduct a systematic review of the impact of community pharmacist interventions on patient adherence to lipid lowering medication (LLM) prescriptions and clinical outcomes. Search method Five databases (MEDLINE, Cochrane Library, Science Direct, Scopus, and Web of Knowledge) were searched systematically to identify relevant reports published by December 2019. Study quality was assessed with the Cochrane risk of bias (RoB 2.0) tool. Selection criteria Controlled trials in which community pharmacists conducted an intervention to improve patient adherence to LLM and clinical outcomes were evaluated. Main results Five studies (2408 participants) were included in the qualitative analysis. Four studies (n = 2266) were pooled in the meta‐analysis. Participants in the intervention group (IG) had better adherence than those in the control group (CG) [odds ratio (OR) = 1.67; 95% confidence interval (CI) 1.38‐2.02; P < 0.001; I 2 = 54%]. Better adherence rates were obtained when adherence was measured with validated questionnaires than when medication‐possession ratio (MPR) measurements were used. Total cholesterol (TC) levels were not included in the meta‐analysis due to data variability among the studies. Conclusions Pharmacist‐led intervention can improve LLM adherence, but its influence on clinical outcomes, including lipid level control, remains to be clarified.