Effectiveness of interventions targeting self-regulation to improve adherence to chronic disease medications: a meta-review of meta-analyses

ABSTRACT

Adherence to chronic disease medication regimens depends in part on successful self-regulation. However, the overall benefit of interventions targeting self-regulatory mechanisms is not well-understood. Accordingly, we conducted a meta-review of meta-analyses assessing the effect of interventions targeting self-regulation on medication adherence. For this meta-review, meta-analyses appearing between January 2006 and March 2019 were eligible if they included experimental trials that assessed the effect of an intervention targeting self-regulation on adherence to chronic disease medication. A systematic literature search of multiple databases for published and unpublished literature identified 16,001 abstracts. Twelve meta-analyses met eligibility criteria and had variable quality according to AMSTAR 2 item completion (M = 50%; range: 31–66%). Overall, meta-reviews showed small to medium effect sizes for interventions that targeted self-monitoring, provided personalised feedback on adherence, or involved complete self-management. Other interventions, such as goal setting, barrier identification and problem solving, and stress management showed little evidence of improving adherence. Only a limited number of self-regulation intervention components were able to be evaluated. Additional research is needed to advance the understanding of the efficacy of adherence interventions focussed on self-regulation by expanding the scope of self-regulation elements targeted (e.g., emotion regulation).

KEYWORDS:

• Meta-review
• chronic disease
• medication adherence
• self-regulation
• behavioural intervention

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Tracey E. Wilson http://orcid.org/0000-0002-2087-8545

Emily A. Hennessy http://orcid.org/0000-0002-5146-5823

Additional information

Funding

This work was supported by National Institute of Nursing Research: [Grant Number R21HL145970,R21NR018348,U24AG052175].