Effectiveness of nurse-led interventions on medication adherence in adults taking medication for metabolic syndrome: A systematic review and meta-analysis

Abstract

Aims and Objectives: To determine the effectiveness of nurse-led interventions on medication adherence, medication knowledge and clinical outcomes in adults taking medication for metabolic syndrome. Background: Despite the significance of interventions designed to improve medication adherence, a systematic review of nurse-led intervention studies for metabolic syndrome is lacking. Design: A systematic review and meta-analysis of randomised controlled trials. Methods: The study was conducted following the PRISMA guidelines checklist. PubMed, EMBASE, PsychINFO, CINAHL, Cochrane CENTRAL and other manual sources were searched in May 2021.The quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Comprehensive Meta-Analysis 3.0 was used to calculate the pooled effect sizes with 95% confidence intervals. Results: This review included 20 studies of nurse-led medication adherence interventions in 6017 adults at risk for metabolic syndrome. The pooled effect size using the random effects model indicated that nurse-led interventions had a significantly moderate impact on enhancing medication adherence and medication knowledge and improving selected clinical outcomes of available studies in nurse-led intervention groups compared with control groups. Duration of intervention (median 12 weeks), mode of delivery (group vs. individual) and using multiple strategies influenced outcomes of nurse-led medication adherence interventions. The results revealed that interventions of moderate- to high-quality studies were more likely to show significant improvements in medication adherence than those of low-quality studies. Conclusion: The meta-analyses showed that nurse-led interventions may enhance medication adherence and knowledge and improve clinical outcomes of this population. Relevance to Clinical Practice: The findings may contribute to evidence-based information about nurse-led intervention and its selection of appropriate interventions for improving medication adherence in this population. Patient or public contribution: Patients or the public were not directly involved in this review.