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Apr 2019, Vol 7, Issue 2
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Medication Adherence Among Women Undergoing Infertility Treatment: A Systematic Review
Diane Mahoney1, Cynthia Russell1, An-Lin Cheng2
1University of Missouri- Kansas City, School of Nursing and Health Studies, Kansas City, Missouri, USA
2University of Missouri- Kansas City, Department of Biomedical and Health Informatics, School of Medicine, Kansas City, Missouri, USA

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Keywords : Medication Adherence, Infertility, Fertility, Fertilization in Vitro, Women
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Objectives :To investigate what is known regarding medication adherence in women undergoing infertility treatment.

Materials and Methods: The data bases PubMed (1940 to 2017), Embase (1980 to 2017), CINAHL (1982 to 2017), PsychINFO (1806 to 2017), and ProQuest dissertations were searched. Inclusion criteria were English-language: (1) prospective,(2) retrospective,(3) observational, (4) cross-sectional, (5) quasi-experimental, and (6) randomized controlled trial studies with medication adherence as a primary or secondary outcome in women with a diagnosis of infertility.Critical appraisal for study quality was assessed using Downs and Black Quality Checklist and STROBE guidelines.

Results: Three articles from 1993 to 2011 were analyzed. Sample sizes varied from 30 to 626 subjects withmean oral medication adherence rates ranging from 26% to 81% when used as first-line therapy. More frequent daily dosing was associated with lower adherence rates.  Adherence was significantly lower when women were concerned about having side effects or reported three or more side effects versus one or two. Women with a body mass index of <23 kg/m²or those who viewed medical treatment as convenient had higher adherence rates. None of the studies assessed medication adherence during controlled ovarian hyperstimulation (COH) cycles in conjunction with intrauterine insemination (IUI) or in vitro fertilization (IVF).

Conclusions:Oral medication adherence rates are suboptimal when used alone as first-line therapy. Further investigation of medication-taking behaviors is warranted in future research trials involving injection medications and COH cycles associated with IUI and IVF cycles to strengthen clinical practice. 

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