Effect of dosing frequency on chronic cardiovascular disease medication adherence

Abstract Background: Many cardiovascular diseases (CVDs) require patients to take one or more long term medications, often administered multiple times a day. We sought to determine the effect of chronic CVD medication dosing frequency on medication adherence. Methods: A search of Medline and Embase...

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Bibliographic Details
Published in:Current medical research and opinion 2012-05, Vol.28 (5), p.669-680
Main Authors: Coleman, Craig I., Roberts, Matthew S., Sobieraj, Diana M., Lee, Soyon, Alam, Tawfikul, Kaur, Rajbir
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Cardiovascular disease
Cardiovascular Diseases - drug therapy
Chronic Disease - drug therapy
Drug Administration Schedule
Electronic monitoring
Humans
Linear Models
Medication Adherence
Medication compliance
Meta-analysis
Middle Aged
Pharmaceutical Preparations - administration & dosage
Prospective Studies
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Summary:Abstract Background: Many cardiovascular diseases (CVDs) require patients to take one or more long term medications, often administered multiple times a day. We sought to determine the effect of chronic CVD medication dosing frequency on medication adherence. Methods: A search of Medline and Embase from 1986 to December 2011 was performed. Included studies used a prospective design, assessed adults with chronic CVDs, evaluated scheduled oral medications administered one to four times daily, and measured adherence for 1 month using an electronic monitoring device. Mixed linear model meta-regression was used to determine how dosing frequency affected adherence using three definitions of increasing strictness: taking, regimen and timing adherence. Results: A total of 29 studies, comprising 41, 29, and 27 dosing frequency arms for the taking, regimen and timing adherence definitions were included. Crude pooled adherence estimates were highest when the lenient taking definition was assessed (range for dosing frequencies: 80.1%-93.1%), and lowest when the strictest timing definition was assessed (range: 57.1%-76.3%). Upon meta-regression, the adjusted weighted mean percentage adherence for twice and three times daily dosing regimens (no studies evaluated four times daily regimens), were 6.9% and 13.7% lower than once daily regimens for the taking, 14.0% and 27.5% lower for the regimen, and 22.9% and 30.4% lower for the timing adherence definition (p 
ISSN:0300-7995
1473-4877
DOI:10.1185/03007995.2012.677419