Cultural relevance in medication adherence interventions with underrepresented adults: Systematic review and meta-analysis of outcomes |
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| Institution: | 1. Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China;2. Department of Eye Tumor and Orbital Disease, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China;1. Leuven Intestinal Failure and Transplantation Center, and Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven 3000, Belgium;2. Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases Metabolism and Ageing, University of Leuven, Leuven, Belgium;1. Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;4. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;3. Insurance Services Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;1. Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA;2. Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH |
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| Abstract: | ObjectiveThis meta-analysis systematically compiles intervention research designed to increase medication adherence among underrepresented adults.MethodComprehensive searching located published and unpublished studies with medication adherence behavior outcomes. Studies were included if samples were adults living in North America who had any of the following backgrounds or identities: African American, Native American, Latino, Latino American, Asian, Asian American, Pacific Islander, Native Alaskan, or Native Hawaiian. Random-effect analyses synthesized data to calculate effect sizes as a standardized mean difference and variability measures. Exploratory moderator analyses examined the association between specific efforts to increase the cultural relevance of medication adherence studies and behavior outcomes.ResultsData were synthesized across 5559 subjects in 55 eligible samples. Interventions significantly improved medication adherence behavior of treatment subjects compared to control subjects (standardized mean difference = 0.211). Primary studies infrequently reported strategies to enhance cultural relevance. Exploratory moderator analyses found no evidence that associated cultural relevance strategies with better medication adherence outcomes.ConclusionThe modest magnitude of improvements in medication adherence behavior documents the need for further research with clear testing of cultural relevance features. |
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