Evidence map›Paper›PMID 28166234›Full record

SynthesisPloS one2017

A systematic review of medication non-adherence in persons with dementia or cognitive impairment.

Daisy Smith, Janaka Lovell, Carolina Weller, Briohny Kennedy, Margaret Winbolt, Carmel Young, Joseph Ibrahim

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
124citing papers in PubMed, 9 pooled it
18.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

124 citing papers in PubMed, 9 syntheses or guidelines pooled it, 224 citations in OpenAlex.

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64 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Daisy SmithDepartment of Forensic Medicine, Monash University, Southbank, Victoria, Australia.
Janaka LovellBallarat Health Services, Ballarat, Victoria, Australia.
Carolina WellerDepartment of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
Briohny KennedyDepartment of Forensic Medicine, Monash University, Southbank, Victoria, Australia.
Margaret WinboltAustralian Centre for Evidence Based Aged Care, College of Science, Health and Engineering, La Trobe University, Victoria, Australia.
Carmel YoungDepartment of Forensic Medicine, Monash University, Southbank, Victoria, Australia.
Joseph IbrahimDepartment of Forensic Medicine, Monash University, Southbank, Victoria, Australia.
Victorian Institute of Forensic Medicine · AUMonash University · AUBallarat Health Services · AULa Trobe University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdherence to medication is vital for disease management while simultaneously reducing healthcare expenditure. Older persons with cognitive impairment (CI) are at risk for non-adherence as cognitive processes are needed to manage medications. This systematic review focuses on the relationship between medication non-adherence and specific cognitive domains in persons with CI, and explores determinants of medication non-adherence. When available, relationships and factors are compared with cognitively intact populations.

methodsA seven database systematic search of studies published between 1 January 1949-31 December 2015 examining medication non-adherence in community dwelling persons with CI or dementia was conducted. Articles reporting medication non-adherence in people with CI or dementia in the community, with or without caregiver supports were eligible for inclusion. Papers reporting adherence to treatments in cognitively intact populations, populations from hospital or institutional settings, for non-prescribed medication or those describing dementia as a factor predicting medication non-adherence were excluded. Data on study and population characteristics, research design, data sources and analysis, specific cognitive domains, non-adherence prevalence, measurement of adherence, salient findings, factors associated with adherence and strategies to improve medication adherence were extracted. Study limitations included inconsistencies between data sources and definitions, resulting in a loss of fidelity in the value and comprehensiveness of data, as well as exclusion of non-pharmacological treatments and regimens.

findingsFifteen studies met inclusion criteria. Adherence among CI subjects ranged from 10.7%-38% with better rates of adherence in non-CI individuals. Medication non-adherence definitions varied considerably. New-learning, memory and executive functioning were associated with improved adherence and formed the focus of most studies. Multiple factors were identified as modulators of non-adherence.

conclusionThis review highlights a gap in knowledge on how specific cognitive domains contribute to medication non-adherence amongst CI populations, and demonstrates the current focus is limited to two domains: memory and executive functioning.

Indexed as

Medication AdherenceCognition DisordersDementiaHumansPatient Outcome AssessmentPhenotypePrescription Drug OveruseRisk FactorsSeverity of Illness Index

Identifiers

PMID28166234
PMCPMC5293218
OpenAlexW2586543796

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.