%0 Journal Article %A Marissa Ayano Mes %A Caroline Brigitte Katzer %A Amy Hai Yan Chan %A Vari Wileman %A Stephanie Jane Caroline Taylor %A Rob Horne %T Pharmacists and medication adherence in asthma: a systematic review and meta-analysis %D 2018 %R 10.1183/13993003.00485-2018 %J European Respiratory Journal %P 1800485 %X The Lancet Asthma Commission highlighted that non-adherence remains a persistent barrier within asthma care. Medical consultations remain pivotal in addressing non-adherence, but interest in additional adherence support from pharmacists is increasing. This systematic review and meta-analysis aims to evaluate how effective pharmacist-led interventions are in improving medication adherence in adults with asthma.Studies were included if they had adult participants with asthma, pharmacist-led or collaborative care interventions, randomised controlled trial (RCT) designs comparing interventions with usual pharmacist care, and a medication adherence outcome. We analysed adherence data using the standardised mean difference (d) and the remaining data was synthesized narratively.From 1159 records, 11 were included in the narrative synthesis and nine in the meta-analysis. The meta-analysis for adherence produced a medium effect size of d=0.49 (SE=0.08, 95% CI 0.35–0.64, p<0.0001) with low statistical heterogeneity.In line with the Perceptions and Practicalities Approach (PAPA), interventions targeted to address both the perceptions and practicalities that influence individual motivation and ability to adhere were more effective. Contextual factors (country and healthcare setting) were also influential. Our findings suggest that with adequate remuneration and integration into asthma care, pharmacists can help improve adherence in asthma.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Ms. Mes reports grants from The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) North Thames, during the conduct of the study; personal fees from Spoonful of Sugar Limited, outside the submitted work; and Ms. Mes's PhD project is affiliated with the Asthma UK Centre for Applied Research (AUKCAR), who covered her attendance fees for AUKCAR Annual Scientific Meetings and AUKCAR PPI Fairs during her PhD.Conflict of interest: Ms. Katzer reports grants from The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) North Thames, during the conduct of the study; personal fees from Spoonful of Sugar Limited, outside the submitted work; and Caroline Katzer's PhD project is affiliated with the Asthma UK Centre for Applied Research (AUKCAR), who covered her attendance fees for AUKCAR Annual Scientific Meetings and AUKCAR PPI Fairs during her PhD.Conflict of interest: Dr. Chan reports grants from Janssen-Cilag, other from Novartis, other from Spoonful of Sugar Ltd, other from Medicines New Zealand, outside the submitted work.Conflict of interest: Dr. Wileman reports grants from The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) North Thames, during the conduct of the study.Conflict of interest: Professor Taylor has nothing to disclose.Conflict of interest: Professor Horne reports grants from National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) North Thames, during the conduct of the study; grants from Asthma UK Centre for Applied Research (AUKCAR), other from Medical Innovation Academic Consortium (CASMI), other from AbbVie, other from Amgen, other from Biogen, other from Idec, other from Gilead Sciences, other from GlaxoSmithKline, other from Janssen, other from Pfizer, other from Roche, other from Shire Pharmaceuticals, other from MSD, other from Astellas, other from AstraZeneca, other from DRSU, other from Novartis, other from Universitatsklinikum Hamburg-Eppendorf, other from Teva Pharmaceuticals, other from Spoonful of Sugar Ltd., outside the submitted work. %U https://erj.ersjournals.com/content/erj/early/2018/06/14/13993003.00485-2018.full.pdf