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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management

Authors: Jessica Langloh de Dassel, Anna P. Ralph, Alan Cass

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Indigenous Australians experience high rates of chronic conditions. It is often asserted Indigenous Australians have low adherence to medication; however there has not been a comprehensive examination of the evidence. This systematic literature review presents data from studies of Indigenous Australians on adherence rates and identifies supporting factors and impediments from the perspective of health professionals and patients.

Methods

Search strategies were used to identify literature in electronic databases and websites. The following databases were searched: Scopus, Medline, CINAHL Plus, PsycINFO, Academic Search Premier, Cochrane Library, Trove, Indigenous Health infonet and Grey Lit.​org. Articles in English, reporting original data on adherence to long-term, self-administered medicines in Australia’s Indigenous populations were included.
Data were extracted into a standard template and a quality assessment was undertaken.

Results

Forty-seven articles met inclusion criteria. Varied study methodologies prevented the use of meta-analysis. Key findings: health professionals believe adherence is a significant problem for Indigenous Australians; however, adherence rates are rarely measured. Health professionals and patients often reported the same barriers and facilitators, providing a framework for improvement.

Conclusions

There is no evidence that medication adherence amongst Indigenous Australians is lower than for the general population. Nevertheless, the heavy burden of morbidity and mortality faced by Indigenous Australians with chronic conditions could be alleviated by enhancing medication adherence. Some evidence supports strategies to improve adherence, including the use of dose administration aids. This evidence should be used by clinicians when prescribing, and to implement and evaluate programs using standard measures to quantify adherence, to drive improvement in health outcomes.
Appendix
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Metadata
Title
A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management
Authors
Jessica Langloh de Dassel
Anna P. Ralph
Alan Cass
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2794-y

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