Effectiveness of Pharmacist-Led Intervention on Medication Adherence in Chronic Diseases: A Systematic Review of Randomized Controlled Trials.

Background: Managing chronic diseases often requires long-term treatment to prevent complications. However, the effectiveness of treatment is often reduced due to poor medication adherence. Poor medication adherence has been associated with 1.1 million hospital days in France and contributes to 200,000 premature deaths in Europe. As primary providers of pharmaceutical care, pharmacists have implemented various intervention strategies to address the problem. Therefore, this study aims to systematically examine the effectiveness of pharmacist-led interventions in improving medication adherence among patients with chronic diseases. Methods: Literature search was conducted using 2 databases (PubMed and EBSCO), focusing on RCTs published until October 2024. These RCTs analyzed the impact of pharmacist-led interventions on medication adherence in chronic diseases, such as hypertension, diabetes, dyslipidemia, asthma, cardiovascular disease, and COPD. Studies on multiple chronic, acute, or mental conditions were excluded. The Risk of Bias 2 tool (RoB2) was used to assess the quality of the studies. Results: Among 75 studies, a total of 26 were included, with the majority conducted in Europe (42%). In addition, 4 types of interventions were identified, including counseling (53.8%), tailored (26.9%), technology-based monitoring (3.85%), and multiple interventions (15.4%). A total of 18 studies (69.2%) demonstrated a significant association between pharmacist-led interventions and medication adherence. The majority measured adherence using self-reported questionnaires. Bias assessment results showed that 7 studies had low risk of bias, 10 had high risk, and 9 had some concerns. Conclusion: Pharmacist-led interventions, such as counseling, tailored, and multiple interventions, can improve medication adherence in chronic diseases. Although pharmacist-led interventions show promising potential, their effectiveness varies depending on the type of intervention and adherence measurements. Further studies are needed to focus on tailored interventions that address patient-specific barriers, ensuring higher efficiency in time, resources, and costs.