Number of studies | Number of participants randomised | Description of interventions | Reported outcomes | Pooled outcomes | Comments |
Simplification of drug regimen versus placebo/usual care | |||||
7 | 4342 | 5 studies: fixed-dose combination (FDC or ‘polypill’) 2 studies: reduction of daily dosing | Adherence; total cholesterol; LDL-C; HDL-C | 4/5 studies with FDC found improved adherence Reduced daily dosing did not improve adherence | Outcomes could not be pooled Outcomes reported for 4320 participants |
Patient education versus usual care | |||||
5 | 9421 | Pharmacist-provided information (videotapes, booklets, educational newsletters, telephone follow-up) | Adherence; LDL-C | Not consistent improvement in adherence or cholesterol | Outcomes could not be pooled Outcomes reported for 8116 participants |
Intensified patient care versus usual care | |||||
16 | 22 785 | Written postal material, telephone or other reminders | Adherence; total cholesterol; LDL-C | ≤6 months: adherence, OR 1.93 (1.29–2.88); TC mean difference (MD) 17.15 (1.17–33.14) >6 months: adherence, OR 2.87 (1.91–4.29); TC MD 17.57 (14.95–20.19) | Outcomes reported for 13 602 participants |
Complex behavioural approaches versus usual care | |||||
1 | 110 | Small-group training followed by postal information | Adherence; total cholesterol; LDL-C; HDL-C | Adherence not improved; HDL-C improved | Outcomes could not be pooled Outcomes reported for 108 participants |
Decision support systems versus usual care/complex behavioural approaches | |||||
2 | 2490 | Adherence information and motivational interviewing | Adherence; LDL-C | Adherence not improved; LDL-C not improved | Outcomes could not be pooled Outcomes reported for 2073 participants |
Administrative improvements versus usual care | |||||
2 | 8148 | 1 study: participant’s drug profile provided to prescriber (including costs of medications dispensed, out of-pocket expenditure, graphic of unfilled prescriptions and days of drug supply): if treatment adherence <80% alert to check with the participant 1 study: medication copayments waived at pharmacy (control group continued to pay copayments) | Adherence; costs | Adherence improved in one study; costs to healthcare system not different, costs to patients reduced in one study | Outcomes could not be pooled Outcomes reported for 7509 participants |
Pharmacy-led interventions versus usual care | |||||
2 | 878 274 | Automated phone calls on days 3 and 7 if prescription remained unpurchased or calls from pharmacist if prescription was not picked up after 8 days; automated phone reminders if refill (over)due | Adherence; LDL-C | Adherence not different; LDL-C reduced (one study) | Outcomes could not be pooled Outcomes reported for 878 260 participants |
HDL, High Density Lipoprotein-Cholesterol; LDL, Low Density Lipoprotein-Cholesterol;TC, Total Cholesterol.