Phase-specific strategies and interventions to enhance medication adherence across different phases in ADHD: a systematic review and meta-analysis

Muhammad Umair Khan*, Syed Shahzad Hasan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Introduction: This systematic review and meta-analysis assessed the characteristics, types, and impact of interventions to improve adherence to attention-deficit hyperactivity disorder (ADHD) medications within the context of the three phases of adherence, namely, initiation, implementation, and discontinuation.

Methods: PubMed, Psychological Information Database, Embase, International Pharmaceutical Abstracts, and Google Scholar were systematically searched for relevant trials using appropriate search terms. Interventions were classified as educational, behavioural, affective, and multifaceted. Data was pooled using odds ratios and proportions.

Results: Seventeen studies were included in this review. In a pooled analysis of four RCTs, interventions did not significantly improve medication adherence (OR = 2.32; 95%-Confidence Interval=CI = 0.91–5.90; p = 0.08). In seven non-randomized trials, a pooled proportion of people who adhered to ADHD medication was considerably higher in the intervention group (85%, 95%CI = 78%-91%) than in the control group (47%, 95%CI = 33%–61%). Interventions varied in terms of study design, methods and their impact on different phases of adherence.

Conclusions: Despite some promising results, the lack of consideration of phase-specific adherence factors may limit the effectiveness and sustainability of interventions to improve adherence in clinical practice. Future interventions should be phase-specific, guided by factors which are pertinent to each phase. Meanwhile, clinicians should choose or tailor interventions based on individual needs and preferences.
Original languageEnglish
JournalExpert Review of Neurotherapeutics
Early online date11 Jun 2024
Publication statusE-pub ahead of print - 11 Jun 2024

Bibliographical note

Copyright © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

Data Access Statement

Data supporting the findings of this study are available within the article and its supplementary materials.


  • Medication adherence
  • intervention
  • ADHD
  • systematic review
  • meta-analysis
  • adherence phases


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