title: Cost-effectiveness of adherence-enhancing interventions: a systematic review.
abstract: Low patient adherence to health-related interventions is a major barrier to achieving healthcare goals and is associated with very high avoidable costs. Although several studies suggest that adherence-enhancing interventions can improve health outcomes, economic evaluations of these interventions are scarce. Systematic reviews published to date are limited to interventions to enhance adherence to pharmaceuticals or to specific diseases and interventions. The authors' objective was to examine the evidence regarding the cost-effectiveness of adherence-enhancing interventions in healthcare and what conclusion could be drawn about these interventions. The present systematic review included 43 original studies and assessed the current evidence regarding the cost-effectiveness of a broad array of interventions aimed at enhancing adherence to medications, medical devices, screening tests and lifestyle behaviors. The authors found that although the majority of adherence-enhancing interventions were cost-effective or cost-saving, variation exists within different intervention types. Further research on the sustainability of adherence improvements is needed in order to accurately evaluate interventions' long-term benefits.
authors.affiliation: a Department of Health Systems Management, Guilford-Glazer Faculty of Business and Management and Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Tzahit
authors.initials: T
authors.lastname: Simon-Tuval
authors.affiliation: b Center for the Evaluation of Value and Risk in Health , Tufts Medical Center , Boston , MA , USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Neumann
authors.affiliation: a Department of Health Systems Management, Guilford-Glazer Faculty of Business and Management and Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods*; D006801:Humans; D055118:Medication Adherence; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance
keywords: adherence; compliance; cost; cost-effectiveness analysis; quality adjusted life-year (QALY); systematic review