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A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases

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Abstract

Medication adherence is a crucial part in the management of rheumatic diseases, especially with many such patients requiring long-term medications. In this paper, we aim to systematically review the literature for the factors associated with medication adherence in the rheumatic patient population. We carried out a systematic literature search using PubMed®, PsychInfo® and Embase ® with relevant keywords and employed the PRISMA® criteria. We included English peer-reviewed articles that studied the factors affecting medication adherence in patients with rheumatic diseases, which were assessed by two independent reviewers. Hand searches were conducted and relevant factors were extracted and classified using the World Health Organization (WHO)’s five dimensions of medication adherence. A simple diagram was drawn to summarise the factors extracted. 1977 articles were identified and reviewed and 90 articles were found to be relevant. A total of 17 factors and 38 sub-factors were identified and categorized based on the WHO’s five dimensions of medication adherence. A hand model for medication adherence was developed to succinctly summarise these dimension to remind clinicians the importance of medication adherence in daily practice. We conducted a systematic review on the various factors including patient, therapy, condition, health system and socioeconomic-related factors that affected medication adherence in rheumatic patients. We found 17 factors and 38 sub-factors that affected medication adherence in this population. This systematic review can facilitate future focused research in unexplored dimensions.

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Authors and Affiliations

  1. Faculty of Science, National University of Singapore, Singapore, Singapore

    Hendra Goh

  2. Faculty of Dentistry, National University of Singapore, Singapore, Singapore

    Yi Seah

  3. Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore

    Yu Heng Kwan & Julian Thumboo

  4. Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore

    Lian Leng Low

  5. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    Warren Fong & Julian Thumboo

  6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Warren Fong & Julian Thumboo

  7. Department of Pharmacy, Khoo Teck Puat Hospital, Singapore, Singapore

    Yu Heng Kwan

  8. Singapore Heart Foundation, Singapore, Singapore

    Yu Heng Kwan

  9. Duke-NUS Medical School, Singapore, Singapore

    Warren Fong

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  1. Hendra Goh
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  3. Yi Seah
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Correspondence to Yu Heng Kwan.

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Co-first authors: Hendra Goh, Yu Heng Kwan and Yi Seah.

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Goh, H., Kwan, Y.H., Seah, Y. et al. A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases. Rheumatol Int 37, 1619–1628 (2017). https://doi.org/10.1007/s00296-017-3763-9

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