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Table 2 Summary of study characteristics

From: Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review

Ref Study design Setting Study duration (months) Total number of participants (N = intervention group where relevant) Type of intervention/ person leading Usual care (if applicable) Adherence outcome
Basheti 2016 Jordan RCT Outpatient Clinic 3 112 (N = 50) Follow up Pharmacist led medication review Routine clinical practice Reduction in self- reported non-adherence in intervention group (P < 0.001) compared with control group (P = 0.168)
Beer 2011 Australia RCT Home setting and residential aged-care facility Unknown 30 (N = 15) Physician led targeted medication withdrawal Usual care No significant difference between the groups P = 0.17
Campins 2017 Spain RCT Primary care centres 12 503 (N = 252) Pharmacist led medication review Routine clinical practice At 6 months adherence was higher in the intervention group (76.4% v 64.1%) P = 0.005
Grymonpre 2001 Canada RCT Community based clinic Variable (from baseline to follow up letter) 135 (N = 69) Pharmacist led medication review Routine clinical practice No significant impact on adherence from baseline to follow-up (P = 0.895)
Haag 2016 USA RCT Primary care outpatient clinic 1 25 (N = 13) Pharmacist led medication review Pre-existing out-patient care transition programme No significant difference in adherence P = 0.65
Hanlon 1996 USA RCT General Medicine Clinic at Veterans Affairs Medical Centre 12 208 (N = 105) Pharmacist led medication review Usual care No significant difference in medication compliance (P = 0.88)
Hedegaard 2015 Denmark RCT Outpatient clinics 12 532 (N = 240) Pharmacist led medication review Routine clinical practice Trend toward improved adherence at 3, 9 and 12 months. Greater % of control group non-adherent compared with intervention group 30.2% vs 20.3% P = 0.01.
Jaeger 2017 Germany RCT GP Practices 9 273 (N = 143) Tailored medication review programme delivered by GPs and Health Care Assistants Routine clinical practice No significant effects on adherence P = 0.11
Lowe 2000 UK RCT General Practice / Home setting 3 161 (N = 77) Pharmacist led review Routine clinical practice Significant difference in mean compliance score (tablet count and self –reported). Intervention group = 91.3% vs 79.5% control group. P < 0.001
Sturgess 2003 Northern Ireland RCT Community Pharmacies 18 191 (N = 110) Community Pharmacist intervention programme Routine Practice Significant increase in compliance and fewer problems with medication compared with control group (P < 0.05)
Vinks 2009 Netherlands RCT Community Pharmacy 4 174 (N = 87) Community Pharmacist review Usual Practice Significant reduction in the number of drug related problems per patient (includes non-compliance) -16.3% (−24.3,-8.3) 95% CI
Messerli 2016 Switzerland RCT Community Pharmacy 7 450 (N = 218) Community Pharmacist Polymedication Check (PMC) Routine practice No significant difference in adherence between the two groups could be observed (p = 0.817)
Chen 2016 Taiwan Prospective cross-sectional Outpatient clinics 3 152 Pharmacist led medication therapy management service   Increase in medication adherence (MMAS-4 scale) from 3.02 to 3.92 (p < 0.001)
Fiss 2013 Germany Prospective cohort Ambulatory primary healthcare 1–24 (mean = 9) 911 (N = 393) Pharmaceutical care from local pharmacy plus medical intervention by GP   Increased in adherence forgetfulness P = 0.001 Increased adherence deliberate p = 0.003 (n = 400) between baseline and follow up
Griffiths 2004 Australia Cohort Community / Home setting 1 N = 24 Community nurse medication review Routine clinical practice No significant difference in non-adherence pre and post intervention (P = 0.237)
Hatah 2014 New Zealand Retrospective cohort Community Pharmacy 6 to 41 N = 353 Community Pharmacist Medicines Use Review (MUR)   No significant difference except during the third visit where more patients with lower adherence scores did not return P < 0.001
Lee 2015 Hong Kong Prospective Uncontrolled Community outreach 8 N = 103 Pharmacist led review Routine clinical practice Significant reduction in Morisky Medication Adherence score P = 0.005
Raynor 2000 UK Cohort Community Pharmacy/home setting 2 N = 143 Community Pharmacist led medication adherence support Routine practice Non-adherence fell from 38% to 14% (P < 0.001)
Roth 2013 USA Prospective Community based primary care medical practice 6 64 Clinical Pharmacist led medication review Routine clinical practice Significant reduction in the number of medication related problems per patient (P < 0.001) which included non- adherence
Steele 2016 USA Prospective Study Home based 3 25 Pharmacist conducted home based medication review Routine practice Non- adherence was significantly reduced (P = 0.012)
Tan 2014 Australia Prospective Study Community clinic/ home setting 6 82 Pharmacist led review Routine practice Significant improvement in adherence (44.1% v 62.7% P = 0.023)
Twigg 2015 UK Service Evaluation Community Pharmacy 6 620 Community Pharmacist Review Routine Practice Significant increase in adherence 0.513 .337 to 0.689) 95% CI