The Burden of Non-Adherence to Cardiovascular Medications Among the Aging Population in Australia: A Meta-Analysis

McKenzie, Samantha J., McLaughlin, Deidre, Clark, Justin and Doi, Suhail A. R. (2015) The Burden of Non-Adherence to Cardiovascular Medications Among the Aging Population in Australia: A Meta-Analysis. Drugs and Aging, 32 3: 217-225. doi:10.1007/s40266-015-0245-1


Author McKenzie, Samantha J.
McLaughlin, Deidre
Clark, Justin
Doi, Suhail A. R.
Title The Burden of Non-Adherence to Cardiovascular Medications Among the Aging Population in Australia: A Meta-Analysis
Journal name Drugs and Aging   Check publisher's open access policy
ISSN 1170-229X
1179-1969
Publication date 2015-03-07
Year available 2015
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s40266-015-0245-1
Open Access Status
Volume 32
Issue 3
Start page 217
End page 225
Total pages 9
Place of publication Northcote, Auckland, New Zealand
Publisher Adis International
Collection year 2016
Language eng
Formatted abstract
Background
Non-adherence to cardiovascular medications is a problem worldwide, even in Australia, which has a socialized medical system, Medicare.

Objective
The aim of this systematic review was to evaluate the burden of non-adherence to cardiovascular medications and factors thereof in Australia.

Data Sources
Pubmed, Embase, CINAHL, PsycInfo, Cochrane Library databases were searched.
Eligibility Criteria
Articles were included if they were in English, peer-reviewed and provided empirical data on adherence to cardiovascular medication for an Australian cohort.

Methods
A meta-analysis of prevalence of medication non-adherence using the double arcsine square root transformed proportion was undertaken. Studies were pooled in homogenous prevalence groups and factors that differed across groups were ascertained.

Results
Five studies, including eight datasets and 76,867 subjects were analyzed. Three more or less homogenous prevalence categories were discernable: low [19 %, 95 % confidence interval (CI) 15–24], moderate (26 %, 95 % CI 23–29) and high (43 %, 95 % CI 43–44; this was a single study) prevalence of non-adherence. There were minimal clear patterns across groups in relation to typical factors of non-adherence (patient, condition, healthcare system or socioeconomic factors). Measurements used for non-adherence were similar for six of the eight included datasets, suggesting this did not affect prevalence of non-adherence or inclusion in a prevalence group.

Conclusions
Non-adherence to cardiovascular medications is a serious problem in the aging Australian setting with an overall prevalence of between 14 and 43 %. The lack of patterns in the typical factors of non-adherence suggests that another factor, such as patients’ beliefs about their conditions and medications, may be playing a stronger role in their non-adherence than clinical or sociodemographic factors. This is an area for further research.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2016 Collection
School of Public Health Publications
 
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