PDF(Pubmed)
Abstract：
UNASSIGNED: Black Americans have a disproportionately increased risk of diabetes, hypertension, and kidney disease, and higher associated morbidity, mortality, and hospitalization rates than their White peers. Structural racism amplifies these disparities, and negatively impacts self-care including medication adherence, critical to chronic disease management. Systematic evidence of successful interventions to improve medication adherence in Black patients with diabetes, hypertension, and kidney disease is lacking. Knowledge of the impact of therapeutic alliance, ie, the unique relationship between patients and providers, which optimizes outcomes especially for minority populations, is unclear. The role and application of behavioral theories in successful development of medication adherence interventions specific to this context also remains unclear.
UNASSIGNED: To evaluate the existing evidence on the salience of a therapeutic alliance in effective interventions to improve medication adherence in Black patients with diabetes, hypertension, or kidney disease.
UNASSIGNED: Medline (via PubMed), EMBASE (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL) (EBSCOhost), and PsycINFO (ProQuest) databases.
UNASSIGNED: Only randomized clinical trials and pre/post intervention studies published in English between 2009 and 2022 with a proportion of Black patients greater than 25% were included. Narrative synthesis was done.
UNASSIGNED: Eleven intervention studies met the study criteria and eight of those studies had all-Black samples. Medication adherence outcome measures were heterogenous. Five out of six studies which effectively improved medication adherence, incorporated therapeutic alliance. Seven studies informed by behavioral theories led to significant improvement in medication adherence.
UNASSIGNED: Study findings suggest that therapeutic alliance-based interventions are effective in improving medication adherence in Black patients with diabetes and hypertension. Further research to test the efficacy of therapeutic alliance-based interventions to improve medication adherence in Black patients should ideally incorporate cultural adaptation, theoretical framework, face-to-face delivery mode, and convenient locations.
UNASSIGNED: To evaluate the existing evidence on the salience of a therapeutic alliance in effective interventions to improve medication adherence in Black patients with diabetes, hypertension, or kidney disease.
UNASSIGNED: Medline (via PubMed), EMBASE (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL) (EBSCOhost), and PsycINFO (ProQuest) databases.
UNASSIGNED: Only randomized clinical trials and pre/post intervention studies published in English between 2009 and 2022 with a proportion of Black patients greater than 25% were included. Narrative synthesis was done.
UNASSIGNED: Eleven intervention studies met the study criteria and eight of those studies had all-Black samples. Medication adherence outcome measures were heterogenous. Five out of six studies which effectively improved medication adherence, incorporated therapeutic alliance. Seven studies informed by behavioral theories led to significant improvement in medication adherence.
UNASSIGNED: Study findings suggest that therapeutic alliance-based interventions are effective in improving medication adherence in Black patients with diabetes and hypertension. Further research to test the efficacy of therapeutic alliance-based interventions to improve medication adherence in Black patients should ideally incorporate cultural adaptation, theoretical framework, face-to-face delivery mode, and convenient locations.
摘要：
未经证实：美国黑人患糖尿病的风险不成比例地增加，高血压,肾脏疾病，和更高的相关发病率，死亡率,和住院率比他们的白人同龄人高。结构性种族主义放大了这些差异，并对包括药物依从性在内的自我护理产生负面影响，对慢性病管理至关重要。成功干预措施提高黑人糖尿病患者服药依从性的系统证据，高血压,缺乏肾脏疾病。了解治疗联盟的影响，ie,患者和提供者之间的独特关系，这优化了结果，特别是对少数民族来说，不清楚。行为理论在成功开发针对这种情况的药物依从性干预措施中的作用和应用也尚不清楚。
UNASSIGNED：为了评估现有的证据，在改善黑人糖尿病患者的药物依从性的有效干预措施中，治疗联盟的显著性，高血压,或肾脏疾病。
未经批准：Medline（通过PubMed），EMBASE(OvidSP),护理和相关健康文献累积指数（CINAHL）（EBSCOhost），和PsycINFO(ProQuest)数据库。
UNASSIGNED：仅包括2009年至2022年间以英文发表的随机临床试验和干预前/后研究，其中Black患者比例超过25％。进行了叙事综合。
未经评估：11项干预研究符合研究标准，其中8项研究全黑样本。药物依从性结果测量是异质的。六项研究中有五项有效改善了药物依从性，合并治疗联盟。以行为理论为依据的七项研究导致药物依从性的显着改善。
UNASSIGNED：研究结果表明，基于治疗联盟的干预措施可有效改善患有糖尿病和高血压的黑人患者的用药依从性。进一步的研究，以测试治疗联盟为基础的干预措施的有效性，以提高黑人患者的药物依从性，应理想地纳入文化适应，理论框架，面对面交付模式，和方便的位置。
UNASSIGNED：为了评估现有的证据，在改善黑人糖尿病患者的药物依从性的有效干预措施中，治疗联盟的显著性，高血压,或肾脏疾病。
未经批准：Medline（通过PubMed），EMBASE(OvidSP),护理和相关健康文献累积指数（CINAHL）（EBSCOhost），和PsycINFO(ProQuest)数据库。
UNASSIGNED：仅包括2009年至2022年间以英文发表的随机临床试验和干预前/后研究，其中Black患者比例超过25％。进行了叙事综合。
未经评估：11项干预研究符合研究标准，其中8项研究全黑样本。药物依从性结果测量是异质的。六项研究中有五项有效改善了药物依从性，合并治疗联盟。以行为理论为依据的七项研究导致药物依从性的显着改善。
UNASSIGNED：研究结果表明，基于治疗联盟的干预措施可有效改善患有糖尿病和高血压的黑人患者的用药依从性。进一步的研究，以测试治疗联盟为基础的干预措施的有效性，以提高黑人患者的药物依从性，应理想地纳入文化适应，理论框架，面对面交付模式，和方便的位置。
