Safe and effective medicines use by consumers
A recent Cochrane review looked at interventions to improve safe and effective medicines use by consumers.
Medicines self-monitoring and self-management programmes appear generally effective to improve medicines use, adherence, adverse events and clinical outcomes; and to reduce mortality in people self-managing antithrombotic therapy. However, some participants were unable to complete these interventions, suggesting they may not be suitable for everyone.
Other promising interventions to improve adherence and other key medicines-use outcomes, which require further investigation to be more certain of their effects, include:·
simplified dosing regimens
interventions involving pharmacists in medicines management, such as medicines reviews and pharmaceutical care services (consultation between pharmacist and patient to resolve medicines problems, develop a care plan and provide follow-up
Several other strategies showed some positive effects, particularly relating to adherence, and other outcomes, but their effects were less consistent overall and so need further study. These included:·
delayed antibiotic prescriptions: effective to decrease antibiotic use but with mixed effects on clinical outcomes, adverse effects and satisfaction;·
practical strategies like reminders, cues and/or organisers, reminder packaging and material incentives:
education delivered with self-management skills training, counselling, support, training or enhanced follow-up;
financial incentives
Immunisation Uptake
Several strategies also showed promise in promoting immunisation uptake, but require further study to be more certain of their effects.
These included
- organisational interventions;
- reminders and recall;
- financial incentives;
- home visits;
- free vaccination;
- lay health worker interventions;
- and facilitators working with physicians to promote immunisation uptake.
Education and/or information strategies also showed some positive but even less consistent effects on immunisation uptake, and need further assessment of effectiveness and investigation of heterogeneity.
Summary
There are many different potential pathways through which consumers’ use of medicines could be targeted to improve outcomes, and simple interventions may be as effective as complex strategies. However, no single intervention assessed was effective to improve all medicines-use outcomes across all diseases, medicines, populations or settings.