RT Journal Article
SR Electronic
T1 Adherence-enhancing interventions for pharmacological and oxygen therapy in patients with COPD: a systematic review and component network meta-analyses
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 240011
DO 10.1183/16000617.0011-2024
VO 33
IS 173
A1 Ammous, Omar
A1 Kampo, Regina
A1 Wollsching-Strobel, Maximilian
A1 Zimmermann, Maximilian
A1 Andreas, Stefan
A1 Friede, Tim
A1 Kroppen, Doreen
A1 Stanzel, Sarah
A1 Salem, Susanna
A1 Windisch, Wolfram
A1 Mathes, Tim
YR 2024
UL http://err.ersjournals.com/content/33/173/240011.abstract
AB Introduction Adherence to COPD management strategies is complex, and it is unclear which intervention may enhance it.Objectives We aim to evaluate the effectiveness of adherence-enhancing interventions, alone or compared to interventions, for patients with COPD.Methods This review comprises a component network meta-analysis with a structured narrative synthesis. We searched MEDLINE, Embase, CENTRAL, CINAHL and trial registries on 9 September 2023. We included controlled studies that explored adherence in patients with COPD. Two review authors independently performed the study selection, data extraction and the risk of bias assessment. We involved patients with COPD in developing this systematic review through focus group interviews and displayed the findings in pre-designed logic models.Results We included 33 studies with 5775 participants. We included 13 studies in the component network meta-analysis that explored adherence. It was mainly assessed through questionnaires. As a continuous outcome, there was a tendency mainly for education (standardised mean difference 1.26, 95% CI 1.13–1.38, very low certainty of evidence) and motivation (mean difference 1.85, 95% CI 1.19–2.50, very low certainty of evidence) to improve adherence. As a dichotomous outcome (e.g. adherent/non-adherent), we found a possible benefit with education (odds ratio 4.77, 95% CI 2.25–10.14, low certainty of evidence) but not with the other components. We included six studies that reported quality of life in the component network meta-analysis. Again, we found a benefit of education (mean difference −9.70, 95% CI −10.82– −8.57, low certainty of evidence) but not with the other components.Conclusions Education may improve adherence and quality of life in COPD patients. Patient focus group interviews indicated that interventions that strengthen patients’ self-efficacy and help them to achieve individual goals are the most helpful.Adherence to medications is a complex process due to multiple factors. Education, as a stand-alone component, likely improves adherence and quality of life. The effect of other components, including motivation and telemedicine, is unclear. https://bit.ly/4ejeVQ4