https://orcid.org/0000-0001-9997-040X
Abstract
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.
Acknowledgments
The authors would like to thank Linda Schoonmade (medical librarian) for her support with composing the search strategy and for performing the searches in different electronic databases.
Disclosure
Dr Marcia Vervloet reports grants from the Netherlands Heart Foundation, during the conduct of the study; grants from AbbVie and Pfizer, outside the submitted work. Dr Joke Korevaar and Dr Chantal Leemrijse report grants from the Netherlands Heart Foundation, during the conduct of the study. Dr. John Paget reports grants from Foundation for Influenza Epidemiology, grants from World Health Organization, grants from Sanofi Pasteur, outside the submitted work. Dr Leah Zullig reports grants from Proteus Digital Health, grants from the PhRMA Foundation, consulting for Novartis, outside the submitted work. Professor Liset van Dijk reports grants from the Netherlands Heart Foundation, during the conduct of the study; grants from Abbvie, grants from Pfizer, outside the submitted work. The authors report no other potential conflicts of interest for this work.