title: [Interventions for improving adherence to treatment in patients with multiple pathologies: overview of systematic reviews].
abstract: OBJECTIVE
  To assess the available scientific evidence regarding the efficacy of interventions aimed to enhance medication adherence in patients with multiple chronic conditions (PMCC).
  
  
  METHODS
  Overview of systematic reviews.
  
  
  METHODS
  The following databases were consulted (September 2013): Pubmed, EMBASE, the Cochrane Library, CRD and WoS to identify interventions aimed to enhance medication adherence in PMCC, or otherwise, patients with chronic diseases common in the PMCC, or polypharmacy.
  
  
  METHODS
  Systematic reviews of clinical trials focused on PMCC or similar were included. They should compare the efficacy of any intervention aimed to improve compliance to prescribed and self-administered medications with clinical practice or other interventions.
  
  
  METHODS
  Information about the study population, nature of intervention and efficacy in terms of improved adherence was extracted.
  
  
  RESULTS
  566 articles were retrieved of which 9 systematic reviews were included. None was specifically focused on PMCC but considered patients with chronic diseases common in the PMCC, patients with more than one chronic disease and polypharmacy. The overall effectiveness of interventions was modest without relevant differences between behavioural, educational and combined interventions. Some components of these interventions including patient counselling and regimen simplification appear to be effective tools in improving adherence in this population group.
  
  
  CONCLUSIONS
  There is a large heterogeneity of interventions aimed to improve adherence with modest efficacy, none in PMCC.
authors.affiliation: Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: javigbueno@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: González-Bueno
authors.affiliation: Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA), Sevilla, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Vega-Coca
authors.affiliation: Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Aitana
authors.initials: A
authors.lastname: Rodríguez-Pérez
authors.affiliation: Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Toscano-Guzmán
authors.affiliation: Departamento de Farmacología, Facultad de Farmacia, Sevilla, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Pérez-Guerrero
authors.affiliation: Unidad de Gestión Clínica de Farmacia, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Santos-Ramos
mesh_terms: D006801:Humans; D055118:Medication Adherence; D000071069:Multiple Chronic Conditions / Q000188:drug therapy*; D019338:Polypharmacy
keywords: Adherence, Interventions; Adherencia; Chronic; Crónico; Intervenciones; Paciente pluripatológico; Patient with multiple chronic conditions; Revisión sistemática; Systematic reviews