Presentation (CTI)

OBJECTIVES: Patients with chronic diseases face many barriers related to medication adherence. However, among the WHO's five dimensions of adherence, socioeconomic factors vary across the population depending on financial stability and income level. Shared decision-making (SDM) engages the patient and their healthcare provider, but it lacks consideration of the economic impact of care. Therefore, this narrative review will synthesize evidence of the effect of cost-informed shared decision-making (CISDM) on patient adherence.
METHODS: This narrative review used PubMed, Cochrane Library, and Google Scholar to identify relevant English-language articles. The search string combined keywords and MeSH terms for shared decision-making, medication adherence, chronic disease, and financial toxicity. The search resulted in 165 articles; however, after considering duplicates and a two-step screening (first abstract, then full-text assessment) for eligibility, this resulted in seventeen relevant articles concerned about medication adherence in chronic disease as an outcome of cost-informed shared decision-making (CISDM). The data will be extracted and synthesized to address the objective of this review.
RESULTS: The review is still underway. The data from the included articles will be synthesized and organized into key thematic areas, including: barriers to medication cost discussion, universal application, the different types of cost-informed shared decision-making, and the impact of the intervention. While the synthesis will identify literature gaps, it will also highlight the effect of discussing medication costs in the SDM process on patient adherence among those who suffer from a chronic condition.
CONCLUSIONS: Ultimately, this review will emphasize the need for CISDM, especially in countries with high Cost-related medication non-adherence (CRN), to improve patient outcomes and adherence.