Cited by 1,353Medication Adherence and CompliancePharmacy and Medical PracticesOpioid Use Disorder Treatment

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A meta-analysis of the association between adherence to drug therapy and mortality

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Simpson, Scot H, Eurich, Dean T, Majumdar, Sumit R, Padwal, Rajdeep S, Tsuyuki, Ross T, Varney, Janice, Johnson, Jeffrey A·2006·BMJ

DOI 10.1136/bmj.38875.675486.55PMC PMC1488752

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Abstract

OBJECTIVE: To evaluate the relation between adherence to drug therapy, including placebo, and mortality. DESIGN: Meta-analysis of observational studies. DATA SOURCES: Electronic databases, contact with investigators, and textbooks and reviews on adherence. Review methods Predefined criteria were used to select studies reporting mortality among participants with good and poor adherence to drug therapy. Data were extracted for disease, drug therapy groups, methods for measurement of adherence rate, definition for good adherence, and mortality. RESULTS: Data were available from 21 studies (46,847 participants), including eight studies with placebo arms (19,633 participants). Compared with poor adherence, good adherence was associated with lower mortality (odds ratio 0.56, 95% confidence interval 0.50 to 0.63). Good adherence to placebo was associated with lower mortality (0.56, 0.43 to 0.74), as was good adherence to beneficial drug therapy (0.55, 0.49 to 0.62). Good adherence to harmful drug therapy was associated with increased mortality (2.90, 1.04 to 8.11). CONCLUSION: Good adherence to drug therapy is associated with positive health outcomes. Moreover, the observed association between good adherence to placebo and mortality supports the existence of the "healthy adherer" effect, whereby adherence to drug therapy may be a surrogate marker for overall healthy behaviour.

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Background
Statin Adherence and Risk of Accidents: A Cautionary Tale
Gersh, B. J. (2010) · Yearbook of Cardiology · doi:10.1016/s0145-4145(09)79739-4 · Cited by 9
Part I: the role of trust in patient noncompliance: a qualitative case study of users of statins for the chronic treatment of high-cholesterol in New York City
Chakraborty, S. (2012) · Journal of Risk Research · doi:10.1080/13669877.2012.727097 · Cited by 9
“These trials ultimately demonstrated that adherence to treatment regimes yielded better outcomes (Osterberg and Blaschke 2005; Simpson et al. 2006).”
Background
[Evidence about the power of intention].
Bonilla, E. (2008) · PubMed · Cited by 9
Improving adherence to prescribed drugs
Neto, A. C. D. A., Aslani, P., & Chen, T. F. (2009) · BMJ · doi:10.1136/bmj.b3282 · Cited by 9
“Non-adherence to prescribed medicines can cause treatment failure, mortality, and increase healthcare costs.”
Background
CPAP or Placebo-effect?
Schwartz, S. W., Cimino, C. R., & Anderson, W. M. (2012) · SLEEP · doi:10.5665/sleep.2218 · Cited by 9
“CPAP or placeboeffect? SLEEP 2012;35(12):1585-1586.”
The Challenges of Estimating Causal Effects of Continuous Positive Airway Pressure Therapy from Observational Data
Donovan, L. M., & Patel, S. R. (2022) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202207-1413le · Cited by 9
Compliance with medical regimen among hematological cancer patients and its association with symptoms of posttraumatic stress disorder and adjustment disorder
Springer, F., Esser, P., Friedrich, M., Ernst, J., Platzbecker, U., Vučinić, V., & Mehnert, A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1278485 · Cited by 9
Primary Care Records of Chronic-Disease Patient Adherence to Treatment
Mesquida, M. M., la Fuente, J. A. D., Lorca, A. M. A., Pillasagua, I. A., Blanco, E. B., Vidal, S. G., Reyes, S. P., Iparraguirre, P. G., Gombau, G. S., & Torán‐Monserrat, P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073710 · Cited by 8
“By way of example, the results of a meta-analysis [5] of 21 studies (46,847 participants) showed that good adherence was associated with lower mortality as compared to poor adherence (odds ratio 0.”
Result
Adherence improvement in patients with ulcerative colitis: a multidisciplinary consensus document
Casellas, F., González‐Lama, Y., Vicens, D. G., García‐López, S., Muñoz, F., Sánchez, L. M., Camacho, L., Cábez, A., Fortes, M. D. P., Gómez, S., et al. (2021) · Revista Española de Enfermedades Digestivas · doi:10.17235/reed.2021.8130/2021 · Cited by 8
Drug Adherence in Hypertension
Burnier, M. (2015) · Springer eBooks · doi:10.1007/978-3-319-15961-4_43 · Cited by 8
Validation of the Identification of Medication Adherence Barriers Questionnaire (IMAB-Q); a Behavioural Science-Underpinned Tool for Identifying Non-Adherence and Diagnosing an Individual’s Barriers to Adherence
Bhattacharya, D., Brown, T. J., Clark, A., Dima, A. L., Easthall, C., Taylor, N. J., & Li, Z. (2023) · Patient Preference and Adherence · doi:10.2147/ppa.s427207 · Cited by 9
Con: can comparing adherent to non-adherent patients provide useful estimates of the effect of continuous positive airway pressure?
Patel, S. R., Sawyer, A. M., & Gottlieb, D. J. (2024) · SLEEP · doi:10.1093/sleep/zsae063 · Cited by 8
Facteurs associés à la non-observance chez les hommes et chez les femmes hypertendus non contrôlés : étude ODACE
Reach, G., Guedj-Meynier, D., Darné, B. M., & Herpin, D. (2015) · Annales de Cardiologie et d Angéiologie · doi:10.1016/j.ancard.2015.04.012 · Cited by 9
Health Action Process Approach: Application to Medication Adherence in Cardiac Rehabilitation (CR) Patients
Greer, A. E., Milner, K. A., Marcello, R. T., & Mazin, K. (2015) · Educational Gerontology · doi:10.1080/03601277.2015.1048147 · Cited by 8
“Such efforts might help CR patients better adhere to their medication regimens, which could ultimately result in decreased morbidity and mortality and reductions in hospital readmissions and health care costs (Dragomir et al., 2010; Simpson et al., 2006).”
Background
Evaluation of pharmacokinetics, user handling, and tolerability of peginterferon alfa-2a (40 kDa) delivered via a disposable autoinjector device
Varunok, P., Lawitz, E., Beavers, Matusow, Leong, Lambert, Bernaards, Solsky, Brennan, Wat, et al. (2011) · Patient Preference and Adherence · doi:10.2147/ppa.s26566 · Cited by 8
National questionnaire of treatment compliance:testing and application in outpatient practice
Фофанова, Т. В., Ageev, F. T., Smirnova, M. D., Николаевна, С. О., Кузьмина, А. Е., Thostov, A. S., & Нелюбина, А. С. (2014) · Systemic Hypertension · doi:10.26442/sg29010 · Cited by 8
Effect of daily azithromycin therapy and adherence on readmission risk in COPD
Krishnan, J. K., Voelker, H. T., Connett, J. E., Niewoehner, D. E., Albert, R. K., Scanlon, P. D., Criner, G. J., Dransfield, M. T., Han, M. K., & Martínez, F. J. (2019) · European Respiratory Journal · doi:10.1183/13993003.01377-2018 · Cited by 8
Association between adherence to antihypertensive medications and health outcomes in middle and older aged community dwelling adults; results from the Irish longitudinal study on ageing
Walsh, C. A., Cahir, C., & Bennett, K. (2019) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-019-02699-w · Cited by 8
Health information–seeking behaviors and adherence to urgent care discharge instructions
Alberti, T. L., & Crawford, S. L. (2019) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000262 · Cited by 8
Work Status Reduction and Cost-Related Nonadherence during Cancer Treatment
Doherty, M. J., Finik, J. M., & Blinder, V. S. (2022) · Health & Social Work · doi:10.1093/hsw/hlac004 · Cited by 8
Preparation, Characterization and in vitro/vivo Evaluation of Long-Acting Rivaroxaban-Loaded Microspheres
Tan, C., & Xiong, S. (2022) · Current Drug Delivery · doi:10.2174/1567201820666221122124510 · Cited by 8
Subtherapeutic hydroxychloroquine concentration is associated with increased disease activity and greater organ damage in lupus
Kang, J., Choi, S., Park, D.-J., & Lee, S. (2023) · Rheumatology · doi:10.1093/rheumatology/kead306 · Cited by 9
Impact of Employer-Sponsored Onsite Pharmacy and Condition Management Programs on Medication Adherence
Aguilar, K. M., Hou, Q., & Miller, R. M. (2015) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2015.21.8.670 · Cited by 8
“conditions, which may result in worsened outcomes and an increased risk of mortality.(2) Additionally, suboptimal medica-”
Background
Non-observance thérapeutique et addiction, deux manifestations de l'impatience
Reach, G. (2010) · Psychotropes · doi:10.3917/psyt.154.0071 · Cited by 10
Risiken und Nebenwirkungen durch Non Compliance
Russmann, S., Curkovic, I., & Huber, M. (2010) · Therapeutische Umschau · doi:10.1024/0040-5930/a000054 · Cited by 8
“Non-Compliance wurde in mehreren Studien mit einer erhöhten Gesamtmortalität assoziiert [9].”
BackgroundInfluential
Patient adherence and preference considerations in managing cardiovascular risk: focus on single pill and amlodipine/atorvastatin fixed combination
Foody, J. M., Aslam, F., & Lee, V. (2009) · Patient Preference and Adherence · doi:10.2147/ppa.s4201 · Cited by 8
“Indeed, recent data have shown that fi xed-dose combination therapies improve patient adherence compared with the coadministration of single-agent formulation(13) and that good adherence to drug therapy is associated with positive health outcomes.(14)”
Adherence, Placebo Effects, and Mortality
Wilson, I. B. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1530-7 · Cited by 8
Tas legemidler som foreskrevet?
Hov, I., Bjartnes, M., Slørdal, L., & Spigset, O. (2012) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.11.0225 · Cited by 8
Selection of interventions aimed at improving medication adherence in patients with multimorbidity
González-Bueno, J., Calvo-Cidoncha, E., Nieto‐Martín, M. D., Pérez‐Guerrero, C., Ollero‐Baturone, M., & Santos‐Ramos, B. (2017) · European Journal of Hospital Pharmacy · doi:10.1136/ejhpharm-2017-001240 · Cited by 8
Homcology: home chemotherapy delivery in a simultaneous care project for frail advanced cancer patients
Chini, C., Bascialla, L., Giaquinto, A., Magni, E., Gobba, S., Proserpio, I., Suter, M. B., Nigro, O., Tinelli, G., & Pinotti, G. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05569-9 · Cited by 9
Against ‘Placebo.’ The Case for Changing our Language, and for the Meaning Response
Moerman, D. E. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-397928-5.00018-0 · Cited by 8
The Challenge of Assessing Adherence to Subcutaneous Biological Drugs in Immune-Mediated Inflammatory Diseases. Letter to the Editor Regarding Michetti P, Weinman J, Mrowietz U, et al. Adv Ther (2017);34:91–108. doi:10.1007/s12325-016-0441-3
Cea‐Calvo, L., Carmona, L., & Alén, J. C. (2017) · Advances in Therapy · doi:10.1007/s12325-017-0602-z · Cited by 8
Electronically Monitored Adherence to Short-Term Antibiotic Therapy in Children
Youngster, I., Gelernter, R., Klainer, H., Paz, H., Kozer, E., & Goldman, M. (2022) · PEDIATRICS · doi:10.1542/peds.2022-058281 · Cited by 7
Factors affecting adherence to medication, smoking cessation, and exercise in patients with peripheral artery disease
Lampridou, S., Rawasdheh, M., Saghdaoui, L. B., Wells, M., & Davies, A. H. (2024) · JVS-Vascular Insights · doi:10.1016/j.jvsvi.2024.100074 · Cited by 7

Authors: Simpson, S. H., Eurich, D. T., Majumdar, S. R., Padwal, R. S., Tsuyuki, R. T., Varney, J., & Johnson, J. A.
Affiliations: University of Alberta (CA)
Institute of Health Economics (CA)
Corresponding author: Simpson, Scot H
ORCID: Simpson, Scot H
Eurich, Dean T
Majumdar, Sumit R
Tsuyuki, Ross T
Johnson, Jeffrey A
Venue: BMJ
Publisher: BMJ
Published: 2006-06-21
Volume: 333
Issue: 7557
Pages: 15
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.38875.675486.55
PMC: PMC1488752
OpenAlex: W2147982456
Cited by: 1,353
References: 39
Citations by year: 2026: 37 · 2025: 40 · 2024: 57 · 2023: 56 · 2022: 55 · 2021: 83 · 2020: 55 · 2019: 74 · 2018: 90 · 2017: 91 · 2016: 69 · 2015: 71 · 2014: 83 · 2013: 77 · 2012: 86
FWCI: 8.08
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations: BMJ (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: medication adherence, pharmacotherapy, mortality, adherence measurement methods
MeSH terms: Drug Therapy, Epidemiologic Methods, Humans, Patient Compliance, Prognosis, Randomized Controlled Trials as Topic

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A meta-analysis of the association between adherence to drug therapy and mortality

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