Study designs of evaluations included in the review
Controlled and uncontrolled, prospective and retrospective and randomised and non-randomised studies were eligible for inclusion. Most of the studies followed up patients for at least 1 year (range: 5 days to 2 years).
Specific interventions included in the review
Studies of interventions to improve patient adherence with medication in which the community pharmacist was the sole health care professional in a community pharmacy setting were eligible for inclusion. The interventions could be aimed at groups or individuals and could include any type of action. Most of the included interventions were based on education, monitoring and (advanced) counselling. Comparator interventions, where these existed, were usual care.
Participants included in the review
Studies of patients who had been prescribed medication for chronic disease (defined as lasting or expected to last longer than 3 months) were eligible for inclusion. The included studies evaluated patients with hypertension, diabetes, asthma, chronic obstructive airways disease, hyperlipidaemia, congestive heart failure and coronary artery disease. The studies included patients who were just starting medication and chronic users. Adherence rates at baseline were generally high.
Outcomes assessed in the review
Studies that assessed patient adherence as a primary or secondary outcome were eligible for inclusion. Adherence could be measured in a variety of stated ways, but drop-outs and withdrawals from the study were not considered as measures of adherence. Most of the included studies assessed adherence using self-report or pill counts; others used pharmacy records or the medication event monitoring system.
How were decisions on the relevance of primary studies made?
Two reviewers independently selected studies and any disagreements were resolved by discussion.