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. 2021 Oct:149:110585.
doi: 10.1016/j.jpsychores.2021.110585. Epub 2021 Jul 26.

Mindfulness-based interventions for medication adherence: A systematic review and narrative synthesis

William R Nardi  1 , Eric B Loucks  2 , Stacey Springs  3 , Don Operario  4 , Ian M Kronish  5 , Brandon A Gaudiano  6 , Shufang Sun  7
Affiliations

Mindfulness-based interventions for medication adherence: A systematic review and narrative synthesis

William R Nardi et al. J Psychosom Res. 2021 Oct.

Abstract

Objective: Inadequate medication adherence is a significant limitation for achieving optimal health outcomes across chronic health conditions. Mindfulness-based interventions (MBIs) have been increasingly applied to promote medical regimen adherence as MBIs have been shown to improve patient-level barriers to adherence (i.e., depressive symptoms, cognitive impairment, stress). The purpose of this review is to investigate the state of research regarding MBIs targeting medication adherence in chronic illnesses and to identify evidence gaps to inform future studies.

Methods: The search reviewed 5 databases (e.g., PubMed, PsycINFO, Embase, CINAHL, Proquest Thesis/Dissertations) to identify trials that quantitatively evaluated the effect of MBIs on medication adherence. Study abstracts and full texts were screened identifying eligible studies, and findings were summarized using a narrative synthesis.

Results: A total of 497 studies were reviewed; 41 were eligible for full text review and 9 were included in narrative synthesis: seven were RCTs and two were pre-post designs. Study quality varied, with five rated moderate or high risk for bias. Clinical populations tested included living with HIV (k = 3), cardiovascular disease (k = 3), psychological disorders (k = 2), and men who underwent a radical prostatectomy (k = 1). Four studies found significant improvements in medication adherence, however only two of these studies had low risk of bias.

Conclusions: Research on MBI's for medication adherence is developing, but the effectiveness of MBIs remains unclear due to the nascent stage of evidence and methodological limitations of existing studies. Researchers should prioritize rigorous experimental designs, theory-driven investigations of behavioral mechanisms, and the use of objective measurements of adherence.

Keywords: Cardiovascular disease; HIV; Medication adherence; Mental health; Mindfulness; Systematic review.

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Conflict of interest statement

COMPETING INTERESTS STATEMENT:

The authors have no competing interests to report.

Figures

Figure 1.
Figure 1.
Flow Diagram of the Study Search and Selection Process
Fig. 2.
Fig. 2.
Risk of Bias Evaluation by Included Study
See this image and copyright information in PMC

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