Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Scope of Outcomes in Trials and Observational Studies of Interventions Targeting Medication Adherence in Rheumatic Conditions: A Systematic Review

Research output: Contribution to journalReviewResearchpeer-review


  1. Is Real-world Evidence Really Real?

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Chronic Pain and Assessment of Pain Sensitivity in Patients With Axial Spondyloarthritis: Results From the SPARTAKUS Cohort

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Hyperoxia and Antioxidants for Myocardial Injury in Noncardiac Surgery: A 2 × 2 Factorial, Blinded, Randomized Clinical Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Prognostic factors for work disability in patients with chronic widespread pain and fibromyalgia: protocol for a cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Ayano Kelly
  • Luke Crimston-Smith
  • Allison Tong
  • Susan J Bartlett
  • Charlotte L Bekker
  • Robin Christensen
  • Mary A De Vera
  • Maarten de Wit
  • Vicki Evans
  • Michael Gill
  • Lyn March
  • Karine Manera
  • Robby Nieuwlaat
  • Shahrzad Salmasi
  • Marieke Scholte-Voshaar
  • Jasvinder A Singh
  • Daniel Sumpton
  • Karine Toupin-April
  • Peter Tugwell
  • Bart van den Bemt
  • Suzanne Verstappen
  • Kathleen Tymms
View graph of relations

OBJECTIVE: Nonadherence to medications is common in rheumatic conditions and associated with increased morbidity. Heterogeneous outcome reporting by researchers compromises the synthesis of evidence of interventions targeting adherence. We aimed to assess the scope of outcomes in interventional studies of medication adherence.

METHODS: We searched electronic databases to February 2019 for published randomized controlled trials and observational studies of interventions with the primary outcome of medication adherence including adults with any rheumatic condition, written in English. We extracted and analyzed all outcome domains and adherence measures with prespecified extraction and analysis protocols.

RESULTS: Overall, 53 studies reported 71 outcome domains classified into adherence (1 domain), health outcomes (38 domains), and adherence-related factors (e.g., medication knowledge; 32 domains). We subdivided adherence into 3 phases: initiation (n = 13 studies, 25%), implementation (n = 32, 60%), persistence (n = 27, 51%), and phase unclear (n = 20, 38%). Thirty-seven different instruments reported adherence in 115 unique ways (this includes different adherence definitions and calculations, metric, and method of aggregation). Forty-one studies (77%) reported health outcomes. The most frequently reported were medication adverse events (n = 24, 45%), disease activity (n = 11, 21%), bone turnover markers/physical function/quality of life (each n = 10, 19%). Thirty-three studies (62%) reported adherence-related factors. The most frequently reported were medication beliefs (n = 8, 15%), illness perception/medication satisfaction/satisfaction with medication information (each n = 5, 9%), condition knowledge/medication knowledge/trust in doctor (each n = 3, 6%).

CONCLUSION: The outcome domains and adherence measures in interventional studies targeting adherence are heterogeneous. Consensus on relevant outcomes will improve the comparison of different strategies to support medication adherence in rheumatology.

Original languageEnglish
JournalJournal of Rheumatology
Issue number10
Pages (from-to)1565-1574
Number of pages10
Publication statusPublished - 1 Oct 2020

    Research areas

  • Clinical trials, Medication adherence, Outcome assessment (health care), Patient compliance, Rheumatic diseases, Systematic review

ID: 61194223