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Interventions to Improve Adherence to Cardiovascular Medication: What About Gender Differences? A Systematic Literature Review

Authors Vervloet M, Korevaar JC, Leemrijse CJ, Paget J, Zullig LL, van Dijk L

Received 29 April 2020

Accepted for publication 5 September 2020

Published 29 October 2020 Volume 2020:14 Pages 2055—2070


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Marcia Vervloet,1 Joke C Korevaar,1 Chantal J Leemrijse,1 John Paget,1 Leah L Zullig,2,3 Liset van Dijk1,4

1Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 2Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA; 3Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina, USA; 4University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmacotherapy, -Epidemiology and -Economics, Groningen, the Netherlands

Correspondence: Marcia Vervloet
Nivel, Netherlands Institute for Health Services Research, P.O. Box 1568, Utrecht 3500 BN, the Netherlands
Tel +31 30 2729713

Background: Compared to men, women have lower treatment rates for cardiovascular disease (CVD), are at higher risk for medication non-adherence and have different reasons for being non-adherent. The aim of this study was to synthesize and evaluate gender-specific adherence-promoting interventions for cardiovascular medication and gender-specific effects of gender-neutral interventions.
Methods: A systematic literature search was performed in PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from January 2007 to October 2019. Intervention studies (with control group) aimed at improving cardiovascular medication adherence with minimally 14 weeks follow-up were included. Two reviewers independently screened titles and abstracts. Full text was obtained for selected abstracts and screened for final inclusion. Data extraction included gender-specific targeting or analysis.
Results: The search identified 6502 citations. After screening title and abstract, full text was obtained from 127 potentially eligible articles. Ultimately, 11 articles were included that analyzed gender differences in gender-neutral interventions. Two reported a gender-specific intervention effect. Using an electronic reminder device, one study increased statin adherence in women. The other found a larger increase in adherence to CVD medication following telephone counseling for men than women. Nine studies did not identify a gender-specific effect.
Conclusion: Despite differences in levels of and reasons for non-adherence, most studies addressing adherence did not analyze potential differences in effect by gender. Moreover, none of the identified studies used gender-specific adherence promoting interventions. Increasing awareness about gender differences in adherence might lead to better tailoring of interventions to gender-specific needs and better results in improving adherence.

Keywords: gender, medication adherence, cardiovascular medication, intervention, systematic review

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