review · Healthcare
Poor medication adherence leads to negative health outcomes and higher healthcare costs. A systematic review evaluated nurse-led interventions aimed at improving adherence among adults with chronic conditions, synthesising twenty-two studies involving 5,975 participants. Findings indicate that nurse-led face-to-face visits significantly improved adherence in five out of seven studies, spanning conditions such as heart failure, hypertension, chronic myeloid leukaemia, and multimorbidity. Mixed approaches incorporating in-person visits and telephone follow-up were effective in four of nine studies, whereas entirely remote interventions succeeded in only one of six. Furthermore, tablet computer-based education performed similarly to nurse-led educational sessions. Motivational approaches were frequently utilised to encourage adherence. While face-to-face nurse interactions show promise in supporting chronic disease management, existing measurement methods may not fully reflect actual medication consumption patterns.
Chronic diseases require consistent treatment, yet poor adherence harms patient health and raises healthcare expenditure. Identifying effective management methods helps healthcare organisations allocate staff and resources efficiently. The findings demonstrate that direct, in-person nurse interaction reliably supports adherence, while digital education delivered via tablet computers can match in-person educational sessions, offering practical guidance for healthcare systems designing chronic care pathways.
The findings are relevant to healthcare providers, clinical software developers, and health services designing chronic disease management programmes. Tablet-based patient education demonstrated results comparable to nurse-led educational sessions, indicating a tested, applied pathway for digital education tools in clinical workflows. However, technology developers should note that entirely remote interventions demonstrated limited effectiveness compared to in-person care.
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Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. Methods: Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. Results: A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. Conclusions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns.
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DOI: 10.3390/healthcare12232337
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