Non-adherence to cardiovascular medications

Electronic Supplementary Material Appendix S1. Detailed search strategies

The burden of non-adherence to cardiovascular medications among the aging population in Australia: A meta-analysis

Drugs and Ageing

Samantha J McKenzie1, PhD

Deirdre McLaughlin1, PhD

Justin Clark2, BA, Lib Tech

Suhail A R Doi1 FRCP, PhD

1The University of Queensland, School of Population Health, Brisbane,

2Australia and Drug Arm Library, Brisbane, Australia.

Correspondence to:

Dr Samantha J McKenzie,

Email:

Pubmed

"Medication Adherence"[Mesh] OR “Medication Compliance” OR “Medication Nonadherence” OR “Medication Non-Compliance” OR “Medication Non Compliance” OR “Medication Noncompliance” OR “Medication Non-Adherence” OR “Medication Non Adherence” or “Medication Persistence”

AND

"Cardiovascular Diseases"[Mesh] OR “Cardiovascular disease” OR “Cardiovascular diseases”

AND

"Australia"[Mesh] OR Australia OR Australian OR Australians

Embase

'patient compliance'/exp OR ‘Medication Adherence" OR “Medication Compliance” OR “Medication Nonadherence” OR “Medication Non-Compliance” OR “Medication Non Compliance” OR “Medication Noncompliance” OR “Medication Non-Adherence” OR “Medication Non Adherence” or “Medication Persistence”

AND

'cardiovascular disease'/exp OR ‘Cardiovascular disease’ OR ‘Cardiovascular diseases’

AND

'australia'/exp OR australia:de,ab,ti OR australian:de,ab,ti OR australians:de,ab,ti

CINAHL

(MH "Medication Compliance") OR "Medication Adherence" OR “Medication Compliance” OR “Medication Nonadherence” OR “Medication Non-Compliance” OR “Medication Non Compliance” OR “Medication Noncompliance” OR “Medication Non-Adherence” OR “Medication Non Adherence” or “Medication Persistence”

AND

(MH "Cardiovascular Diseases+") OR “Cardiovascular disease” OR “Cardiovascular diseases”

AND

(MH "Australia+") OR Australia OR Australian OR Australians

PsycINFO

(Treatment Compliance) OR “Medication Compliance” OR “Medication Nonadherence” OR “Medication Non-Compliance” OR “Medication Non Compliance” OR “Medication Noncompliance” OR “Medication Non-Adherence” OR “Medication Non Adherence” or “Medication Persistence”

AND

(Cardiovascular Disorders) OR (Cardiovascular Reactivity) OR (Cardiovascular System) OR “Cardiovascular disease” OR “Cardiovascular diseases”

AND

Australia OR Australian OR Australians

Cochrane Library

"Medication Adherence" OR “Medication Compliance” OR “Medication Nonadherence” OR “Medication Non-Compliance” OR “Medication Non Compliance” OR “Medication Noncompliance” OR “Medication Non-Adherence” OR “Medication Non Adherence” or “Medication Persistence”

AND

"Cardiovascular Diseases" OR “Cardiovascular disease” OR “Cardiovascular diseases”

AND

"Australia" OR Australia OR Australian OR Australians

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Non-adherence to cardiovascular medications

Electronic Supplementary Material Appendix Table S1.

Electronic supplementary material appendix Table S1: Quality scoring of included studies based on Hoy et al. [22] in decreasing order of quality.

Study / Representative / Sample frame / Random selection / Non- response bias / Direct data / Case definition / Instrument / Same data collection / Length of period / Numerators denominators / Total score / Rescaled score
[35] Warren et al. Pharmacoepidemiol Drug Saf 2013; 22(12): 1298-307 / 0 / 1 / 1 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 8 / 1
[25] Roughead et al. Eur J Cardiovasc Prev Rehabil. 2010; 17(1):71-6 / 0 / 1 / 1 / 1 / 0 / 1 / 1 / 1 / 1 / 1 / 8 / 1
[34] Gujral et al. Int J Clin Pharm 2014; 36:1048-58 / 0 / 1 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1 / 7 / 0.88
[36] Percival et al. Int J Clin Pharm 2012; 34(4):618-25 / 0 / 1 / 0 / 0 / 1 / 1 / 1 / 1 / 0 / 1 / 6 / 0.75
[33] Gallagher et al. J Nurs Healthc Chronic Illn. 2011; 3(1):30-40 / 0 / 0 / 0 / 1 / 1 / 1 / 0 / 0 / 0 / 1 / 4 / 0.4

1=safeguard present; 0=otherwise

Electronic Supplementary Material Appendix Table S2.

Electronic supplementary material appendix Table S2. Characteristics of included studies in order of decreasing proportion of non-adherence

Non-adherence subgroup / Study / Medication / Non-adherent N / Total N / Proportion of non-adherent / Quality assessment score / Subjects / Data source / Data collection / Age (SD) / Male % / Non-adherence definition
High / [35] Warren et al. Pharmacoepidemiol Drug Saf 2013; 22(12): 1298-307 / Statins / 6,969 / 16,110 / 0.43 / 0.8 / General beneficiary / PBS / Jan 09 – Dec 10 / 45+ / 61 / Medication possession ratio less than 80% calculated by proportion of days covered by dispensing statins to the patient in 2009 - 2010, dividing by 24
Moderate / [25] Roughead et al. Eur J Cardiovasc Prev Rehabil. 2010; 17(1):71-6. / CCB / 1,186 / 4,191 / 0.28 / 0.8 / Gold card veterans with hospitalization for acute MI, angina, ischemic heart disease who were dispensed CVD meds / DVA pharmacy claims / Jan 01 – Jun 07 / 77.2 (7.9) men. 78.1 (5.9) women. / 74 / Insufficient medicine dispensed as measured by pack size to cover less than 80% of the treatment while dispensed therapy
Moderate / [34] Gujral et al. Int J Clin Pharm 2014; 36:1048-58 / Lipid lowering agent / 16 / 65 / 0.25 / 0.7 / Convenience sample of patients in tertiary hospital and had MI; Control group only / Community pharmacy records / Oct 09 - Aug 10 / 60.4 (11.3) / 80 / Medication possession ratio less than 80% calculated by dividing the cumulative number of days of supply by the total number of days in the measuring interval (1 year), multiplied by 100%
Moderate / [25] Roughead et al. Eur J Cardiovasc Prev Rehabil. 2010; 17(1):71-6. / ACEI / ARB / 1,672 / 6,691 / 0.25 / 0.8 / Gold card veterans with hospitalization for acute MI, angina, ischemic heart disease who were dispensed CVD meds / DVA pharmacy claims / Jan 01 – Jun 07 / 77.2 (7.9) men. 78.1 (5.9) women. / 74 / Insufficient medicine dispensed as measured by pack size to cover less than 80% of the treatment while dispensed therapy
Low / [33] Gallagher et al. J Nurs Healthc Chronic Illn. 2011; 3(1):30-40 / Any heart failure medication / 11 / 50 / 0.22 / 0.4 / Convenience sample of heart failure patients who had exacerbation of illness (hospitalization or more services needed) / Home interview patient recall / April 05 – June 06 / 75 (8) / 67 / Did not take medication exactly as prescribed: medication adherence was determined by asking participants
of the manner in which they took individual medicines.
A score point was given for each medicine taken at the
prescribed dose and daily frequency, so that both intentional
and non-intentional adherence was captured, but not differentiated.
A medication adherence score was then calculated
based on the overall percentage of medicines taken as
prescribed for all medication doses and frequencies. Adherence scores therefore had a
potential range of 0–100, with higher scores representing
better adherence. Length of period over which adherence was measured was not provided.
Low / [35] Warren et al. Pharmacoepidemiol Drug Saf 2013; 22(12): 1298-307 / Statins / 8,459 / 42,492 / 0.20 / 0.8 / Concession card holders / PBS / 2009 – 2010 / 45+ / 48 / Medication possession ratio less than 80% calculated by proportion of days covered by dispensing statins to the patient in 2009 - 2010, dividing by 24
Low / [25] Roughead et al. Eur J Cardiovasc Prev Rehabil. 2010; 17(1):71-6. / Lipid lowering statin / 1,163 / 7,225 / 0.16 / 0.8 / Gold card veterans with hospitalization for acute MI, angina, ischemic heart disease who were dispensed CVD meds / DVA pharmacy claims / Jan 01 – Jun 07 / 77.2 (7.9) men. 78.1 (5.9) women. / 74 / Insufficient medicine dispensed as measured by pack size to cover less than 80% of the treatment while dispensed therapy
Low / [36] Percival et al. Int J Clin Pharm 2012; 34(4):618-25 / Any heart failure medication / 6 / 43 / 0.14 / 0.75 / Heart failure clinic patients / Questionnaire / Feb 10 – May 10 / 64.2 (17.1) / 84 / Medication Adherence Report Scale score less than 23 for the 4- month data collection period

ACEI = angiotensin converting enzyme inhibitors; ARB = angiotensin receptor blockers; CCB = calcium channel blocker; CVD = cardiovascular disease; DVA = Department of Veteran’s Affairs; MI = myocardial infarction; PBS = Pharmaceutical Benefits Scheme

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