Pearce, Christina Joanne;
Chan, Amy Hai Yan;
Jackson, Tracy;
Fleming, Louise;
Foot, Holly;
Bush, Andy;
Horne, Rob;
(2022)
Features of successful interventions to improve adherence to Inhaled Corticosteroids in children with asthma.
Pediatric Pulmonology
10.1002/ppul.25838.
(In press).
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Abstract
INTRODUCTION: Non-adherence to inhaled corticosteroids (ICS) in children with asthma leads to significant morbidity and mortality. Few adherence interventions have been effective, and little is known about what contributes to intervention effectiveness. This systematic review summarises the efficacy and the characteristics of effective interventions. METHODS: Six databases were systematically searched on 3rd October 2020 for randomised control trials measuring adherence to ICS in children with asthma. A narrative synthesis was conducted focusing on intervention efficacy and study reliability. Intervention content was coded based on the NICE guidelines for medicines adherence (The Perceptions and Practicalities Approach, PAPA) and Behaviour Change Techniques (BCT), to determine the effective aspects of the intervention. RESULTS: Of 240 studies identified, 25 were eligible for inclusion. Thirteen of the twenty-five studies were categorised as being highly reliable. Nine of the thirteen interventions were effective at increasing adherence and six of those met the criteria for a PAPA intervention. Techniques targeting perceptions and practicalities in successful interventions included rewards; reminders; feedback and monitoring of adherence; pharmacological support; instruction on how to take their ICS/adhere and information about triggers for symptoms and non-adherence. CONCLUSION: Adherence interventions in children with asthma have mixed effectiveness. Effective intervention studies were more frequently of higher quality, were tailored to individuals' perceptual and practical adherence barriers, and used multiple BCTs. However, due to the small number of included studies and varying study design quality, conclusions drawn here are preliminary. Future research is needed to test a PAPA-based intervention with a rigorous study design. This article is protected by copyright. All rights reserved.
| Type: | Article |
|---|---|
| Title: | Features of successful interventions to improve adherence to Inhaled Corticosteroids in children with asthma |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/ppul.25838 |
| Publisher version: | https://doi.org/10.1002/ppul.25838 |
| Language: | English |
| Additional information: | © 2022 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Adherence, asthma, children, inhaled corticosteroids, intervention, systematic review |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10144264 |
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