Adherence enhancing interventions for pharmacological and oxygen therapy in patients with COPD: protocol for a systematic review and component network meta-analyses.
Adherence
COPD
Complex intervention
GRADE
Network meta-analysis
Risk of bias
Journal
Systematic reviews
ISSN: 2046-4053
Titre abrégé: Syst Rev
Pays: England
ID NLM: 101580575
Informations de publication
Date de publication:
08 09 2023
08 09 2023
Historique:
received:
27
10
2022
accepted:
18
08
2023
medline:
11
9
2023
pubmed:
9
9
2023
entrez:
8
9
2023
Statut:
epublish
Résumé
Chronic obstructive pulmonary disease (COPD) is characterised by hyperinflation and expiratory airflow limitation due to long-term exposure to irritants. The variety and complexity of COPD treatment and the possible added comorbidities may make the patients find it difficult to cope with the required medications. That is why supporting patients' adherence is critical because not taking medications correctly increases the risk of complications and creates an additional financial burden. A range of interventions aiming to improve patient adherence were used, and most of them are complex since they involve a mix of elements. Furthermore, despite the variety of available tools, assessing adherence is challenging because clinicians usually do not get a concrete judgement if their patients followed their treatment plan reliably. We aim to evaluate the effectiveness of adherence-enhancing interventions for COPD patients, explore which intervention (component) works for which patients and check the factors influencing the implementation and participant responses. We will perform a comprehensive literature search (Medline, Embase, Cochrane Library, trial registries) without restrictions on language and publication status, and we will include all controlled studies investigating the effect of adherence-enhancing intervention on patients with COPD. We plan to involve COPD patients in the systematic review development through two patient interviews (one before and one after the systematic review). Two reviewers will perform the screening, data extraction and risk of bias (ROB) assessment. For ROB, we will use ROB 2.0 to assess randomised controlled trials, and ROBINS-I to assess non-randomised studies. We will perform pair-wise random-effects meta-analyses and component network meta-analyses to identify the most effective components and combinations of components. We will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence. To determine the degree of complexity, we will use the iCAT_SR checklist, and then, following a logical model, we will group the interventions according to prespecified criteria. This systematic review aims to point out the most effective and implementable adherence-enhancing interventions by using methods for synthesising evidence on complex interventions and involving COPD patients all along with the review process. PROSPERO CRD42022353977.
Sections du résumé
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is characterised by hyperinflation and expiratory airflow limitation due to long-term exposure to irritants. The variety and complexity of COPD treatment and the possible added comorbidities may make the patients find it difficult to cope with the required medications. That is why supporting patients' adherence is critical because not taking medications correctly increases the risk of complications and creates an additional financial burden. A range of interventions aiming to improve patient adherence were used, and most of them are complex since they involve a mix of elements. Furthermore, despite the variety of available tools, assessing adherence is challenging because clinicians usually do not get a concrete judgement if their patients followed their treatment plan reliably. We aim to evaluate the effectiveness of adherence-enhancing interventions for COPD patients, explore which intervention (component) works for which patients and check the factors influencing the implementation and participant responses.
METHODS
We will perform a comprehensive literature search (Medline, Embase, Cochrane Library, trial registries) without restrictions on language and publication status, and we will include all controlled studies investigating the effect of adherence-enhancing intervention on patients with COPD. We plan to involve COPD patients in the systematic review development through two patient interviews (one before and one after the systematic review). Two reviewers will perform the screening, data extraction and risk of bias (ROB) assessment. For ROB, we will use ROB 2.0 to assess randomised controlled trials, and ROBINS-I to assess non-randomised studies. We will perform pair-wise random-effects meta-analyses and component network meta-analyses to identify the most effective components and combinations of components. We will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the quality of evidence. To determine the degree of complexity, we will use the iCAT_SR checklist, and then, following a logical model, we will group the interventions according to prespecified criteria.
DISCUSSION
This systematic review aims to point out the most effective and implementable adherence-enhancing interventions by using methods for synthesising evidence on complex interventions and involving COPD patients all along with the review process.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022353977.
Identifiants
pubmed: 37684691
doi: 10.1186/s13643-023-02326-x
pii: 10.1186/s13643-023-02326-x
pmc: PMC10486002
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
159Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Respir Care. 2015 Feb;60(2):297-303
pubmed: 25185152
Int J Chron Obstruct Pulmon Dis. 2018 May 24;13:1683-1690
pubmed: 29872286
J Clin Epidemiol. 2017 Mar;83:37-47
pubmed: 27498377
BMC Med Res Methodol. 2017 Nov 28;17(1):152
pubmed: 29179685
BMJ. 2001 Sep 22;323(7314):647
pubmed: 11566816
Res Synth Methods. 2017 Mar;8(1):79-91
pubmed: 27362487
Cochrane Database Syst Rev. 2020 May 8;5:CD012419
pubmed: 32383493
BMC Med Res Methodol. 2017 Apr 26;17(1):76
pubmed: 28446138
Res Synth Methods. 2011 Mar;2(1):33-42
pubmed: 26061598
East Mediterr Health J. 2019 Mar 19;25(1):47-57
pubmed: 30919925
Res Social Adm Pharm. 2019 Apr;15(4):358-365
pubmed: 29801918
J Clin Epidemiol. 2019 Jul;111:105-114
pubmed: 29432858
Res Synth Methods. 2016 Mar;7(1):55-79
pubmed: 26332144
Pharmacoeconomics. 2015 May;33(5):467-88
pubmed: 25663178
Br J Clin Pharmacol. 2012 May;73(5):691-705
pubmed: 22486599
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Cochrane Database Syst Rev. 2019 May 20;5:CD010919
pubmed: 31106396
J Clin Epidemiol. 2014 Oct;67(10):1076-82
pubmed: 25087180
Cochrane Database Syst Rev. 2021 Sep 8;9:CD013381
pubmed: 34496032
J Clin Epidemiol. 2011 Aug;64(8):861-71
pubmed: 21531537
Eur Geriatr Med. 2020 Jun;11(3):369-381
pubmed: 32297271
Respir Res. 2017 Apr 21;18(1):67
pubmed: 28431503
Int J Nurs Stud. 2007 Nov;44(8):1468-77
pubmed: 16973166
Res Synth Methods. 2018 Sep;9(3):366-381
pubmed: 29573180
Int J Clin Pharm. 2014 Feb;36(1):15-9
pubmed: 24293282
Int J Chron Obstruct Pulmon Dis. 2021 Jul 06;16:2001-2021
pubmed: 34262270
J Clin Epidemiol. 2017 Oct;90:6-10
pubmed: 28720511
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Pharmacoepidemiol Drug Saf. 2007 Apr;16(4):441-8
pubmed: 17006959
Res Synth Methods. 2020 Sep;11(5):617-626
pubmed: 32472632
Res Synth Methods. 2021 Jan;12(1):55-61
pubmed: 32336025
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
Trials. 2011 Feb 14;12:40
pubmed: 21320300
Respir Med. 2017 Aug;129:117-123
pubmed: 28732818
J Med Libr Assoc. 2020 Oct 01;108(4):556-563
pubmed: 33013212
BMC Pulm Med. 2020 Sep 25;20(1):253
pubmed: 32977779
Int J Chron Obstruct Pulmon Dis. 2010 Nov 24;5:401-6
pubmed: 21191434
Int J Chron Obstruct Pulmon Dis. 2020 Feb 26;15:439-460
pubmed: 32161455
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
Stat Med. 2015 Mar 30;34(7):1097-116
pubmed: 25446971
Biom J. 2020 May;62(3):808-821
pubmed: 31021449
Res Synth Methods. 2020 Jan;11(1):74-90
pubmed: 31348846
BMJ Glob Health. 2019 Jan 25;4(Suppl 1):e000858
pubmed: 30775014
J Thorac Dis. 2014 Jun;6(6):656-62
pubmed: 24976987
J Allergy Clin Immunol. 2006 Oct;118(4):899-904
pubmed: 17030244
Respiration. 2011;82(4):328-34
pubmed: 21454953
Health Policy. 2002 Jan;59(1):65-94
pubmed: 11786175
J Clin Epidemiol. 2011 Nov;64(11):1198-207
pubmed: 21463926
Eur J Clin Pharmacol. 2017 Nov;73(11):1475-1489
pubmed: 28779460
Respir Med. 2004 Aug;98(8):752-9
pubmed: 15303640
Chest. 2013 Sep;144(3):766-777
pubmed: 23429910
Am J Geriatr Pharmacother. 2012 Jun;10(3):201-10
pubmed: 22521808
Am J Respir Crit Care Med. 1995 Aug;152(2):580-8
pubmed: 7633711
J Asthma. 2000 May;37(3):225-34
pubmed: 10831147
Respir Med. 2014 Jan;108(1):103-13
pubmed: 24070566
Eur J Health Econ. 2020 Mar;21(2):181-194
pubmed: 31564007
J Clin Epidemiol. 2011 Apr;64(4):383-94
pubmed: 21195583
Syst Rev. 2017 Mar 23;6(1):61
pubmed: 28335799
Res Synth Methods. 2018 Mar;9(1):13-24
pubmed: 28677339