Adherence enhancing interventions for pharmacological and oxygen therapy in patients with COPD: protocol for a systematic review and component network meta-analyses

Systematic Reviews

Protocol

Stefan Andreas¹  Sarah Schwarz²  Wolfram Windisch²  Maximilian Wollsching-Strobel²  Tim Friede³  Susanna Salem³  Regina Kampo³  Omar Ammous³  Tim Mathes⁴ 

[1] Clinic for Pneumology/Krs. Kassel, Immenhausen, Germany;Clinic for Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany;Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany;Witten/Herdecke University, Witten, Germany;Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany;Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany;Department of Evidence-Based Health Services Research (Institute for Research in Operative Medicine), Witten/Herdecke University, Witten, Germany;

关键词: COPD;    Adherence;    Complex intervention;    Risk of bias;    GRADE;    Network meta-analysis;   

DOI  :  10.1186/s13643-023-02326-x

 received in 2022-10-27, accepted in 2023-08-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundChronic 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.MethodsWe 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.DiscussionThis 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 registrationPROSPERO CRD42022353977

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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