Kassavou, Aikaterini;
Choi, Yan Yee Cherizza;
Fineberg, Micah;
(2023)
Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis.
Behavioural Science
, 13
(3)
, Article 246. 10.3390/bs13030246.
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Abstract
Background: Stroke affects more than 30 million people every year, but only two-thirds of patients comply with prescribed medication, leading to high stroke recurrence rates. Digital technologies can facilitate interventions to support treatment adherence. Purpose: This study evaluates the effectiveness of remote interventions and their mechanisms of action in supporting medication adherence after stroke. Methods: PubMed, MEDLINE via Ovid, Cochrane CENTRAL, the Web of Science, SCOPUS, and PsycINFO were searched, and meta-analysis was performed using the Review Manager Tool. Intervention content analysis was conducted based on the COM-B model. Results: Ten eligible studies were included in the review and meta-analysis. The evidence suggested that patients who received remote interventions had significantly better medication adherence (SMD 0.49, 95% CI [0.04, 0.93], and p = 0.03) compared to those who received the usual care. The adherence ratio also indicated the interventions’ effectiveness (odds ratio 1.30, 95% CI [0.55, 3.10], and p = 0.55). The systolic and diastolic blood pressure (MD −3.73 and 95% CI [−5.35, −2.10])/(MD −2.16 and 95% CI [−3.09, −1.22]) and cholesterol levels (MD −0.36 and 95% CI [−0.52, −0.20]) were significantly improved in the intervention group compared to the control. Further behavioural analysis demonstrated that enhancing the capability within the COM-B model had the largest impact in supporting improvements in adherence behaviour and relevant clinical outcomes. Patients’ satisfaction and the interventions’ usability were both high, suggesting the interventions’ acceptability. Conclusion: Telemedicine and mHealth interventions are effective in improving medication adherence and clinical indicators in stroke patients. Future studies could usefully investigate the effectiveness and cost-effectiveness of theory-based and remotely delivered interventions as an adjunct to stroke rehabilitation programmers.
| Type: | Article |
|---|---|
| Title: | Effectiveness of Remote Interventions to Improve Medication Adherence in Patients after Stroke: A Systematic Literature Review and Meta-Analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/bs13030246 |
| Publisher version: | https://doi.org/10.3390/bs13030246 |
| Language: | English |
| Additional information: | © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
| Keywords: | medication adherence; stroke patients; telemedicine; mHealth |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10166422 |
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