What Do We Know about Medication Adherence Interventions in Inflammatory Bowel Disease, Multiple Sclerosis and Rheumatoid Arthritis? A Scoping Review of Randomised Controlled Trials

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose:
Between 53–75% of people with inflammatory bowel disease, 30-80% with rheumatoid arthritis and up to 50% with multiple sclerosis do not take medications as prescribed to maintain remission. This scoping review aimed to identify effective adherence interventions for inflammatory bowel disease, but with few studies found, multiple sclerosis and rheumatoid arthritis were included to learn lessons from other conditions.

Patients and methods:
Full and pilot randomised controlled trials testing medication adherence interventions for inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis conducted between 2012-2021, were identified in six electronic databases.

Results:
3024 participants were included from 24 randomised controlled trials; ten pilot and 14 full studies. Eight investigated inflammatory bowel disease, 12 rheumatoid arthritis and four multiple sclerosis. Nine studies (37.5%) reported significantly improved medication adherence; all involving tailored, personalised education, advice or counselling by trained health professionals, with five delivered face-to-face and 1:1. Quality of effective interventions was mixed; five rated high quality, two medium and two low quality.
Interventions predominantly using technology were likely to be most effective. Secondary tools such as diaries, calendars and advice-sheets were also efficient in increasing adherence. Only 10 interventions were based on an adherence theory, of which four significantly improved adherence.

Conclusions:
Tailored, face to face, 1:1 interaction with healthcare professionals were successful at providing personalised adherence support. Accessible, user-friendly technology-based tools supported by calendars and reminders effectively enhanced adherence.
Key components of effective interventions should be evaluated and integrated further into clinical practice if viable, whilst being tailored to inflammatory conditions.
Original languageEnglish
Pages (from-to)3265-3303
Number of pages39
JournalPatient Preference and Adherence
Volume17
Early online date13 Dec 2023
DOIs
Publication statusPublished - 2023

Keywords

  • Inflammatory bowel disease
  • Adherence
  • Medication
  • Medicine;
  • Treatment;
  • Drugs;
  • Rheumatoid arthritis
  • IBD
  • MS
  • RA
  • Multiple sclerosis
  • Concordance
  • Compliance

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