Effects of health education on medication adherence in patients with osteoporosis: a Meta-analysis / 中华风湿病学杂志

ABSTRACT

Objective:To systematically evaluate the effect of personalized health education on adherence to osteoporosis therapy.Methods:Literatures related to the effect of health education intervention on the medication adherence of patients with osteoporosis with the core contents of guiding standardized medication, long-term medication, adherence to medication, and improvement of patients' health knowledge of diseases published from 1990 to 2021 were searched in the Chinese national knowledge infrastructure (CNKI), Wanfang data database, Chinese biomedical literature database (CBM), Medline, Embase, web of science, The Cochrane Library databases and combining with the related journals of handicrafts. Review manage 5.3 was used to evaluate the heterogeneity of included literature. Fixed effect model or random effect model was used to combine the effect quantity. Stata 16.0 was used to evaluate the publication bias, sensitivity analysis, subgroup analysis and meta regression.Results:A total of 1 924 articles were retrieved and finally 24 randomized-controlled trial (RCTs) were included, including 11 248 patients with osteoporosis in which 5 742 cases with health education, and 5 506 cases with regular care. The literature evaluation showed that the included studies had high heterogeneity, and studies with subjects aged 50-60 [ RR (95% CI)=0.475 (0.344, 0.657), P=0.460], located in North America [ RR (95% CI)=0.888 (0.831, 0.948), P=0.232] and with a sample size greater than 500 [ RR (95% CI)=0.761 (0.660, 0.878), P=0.152] had high homogeneity. Meta-analysis showed that compared with the regular care group, the health education group had higher medication adherence [ RR(95% CI)=0.78(0.69, 0.87), P<0.001]. Conclusion:Osteoporosis patients need to have medication therapy for a long period of time. Individualized health education guidance with long-term medication, standardized medication and adherence to medication can enhance patients' awareness of osteoporosis and can improve adherence to osteoporosis therapy, thus have important effect on the treatment of osteoporosis