Annette de Thurah

Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: systematic reviews informing the 2020 EULAR points to consider

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Valentin Ritschl, Medical University of Vienna
  • ,
  • Tanja A. Stamm, Medical University of Vienna
  • ,
  • Daniel Aletaha, Medical University of Vienna
  • ,
  • Johannes W.J. Bijlsma, Utrecht University
  • ,
  • Peter Böhm, Deutsche Rheuma-Liga Bundesverband e.V
  • ,
  • Razvan Dragoi, Victor Babes University of Medicine and Pharmacy
  • ,
  • Emma Dures, University of the West of England, University Hospitals Bristol NHS Foundation Trust
  • ,
  • Fernando Estévez-López, Erasmus University Rotterdam
  • ,
  • Laure Gossec, Sorbonne Université
  • ,
  • Annamaria Iagnocco, University of Turin
  • ,
  • José B. Negrón, Instituto de Investigación Social y Sanitaria
  • ,
  • Michal Nudel
  • ,
  • Andréa Marques, University of Coimbra
  • ,
  • Ellen Moholt, Diakonhjemmet Hospital
  • ,
  • Conni Skrubbeltrang, Aalborg Universitet
  • ,
  • Bart Van den Bemt, Pharmacy, Radboud University Nijmegen
  • ,
  • Kirsten Viktil, University of Oslo, Diakonhjemmet Hospital
  • ,
  • Marieke Voshaar, University of Twente
  • ,
  • Loreto Carmona, Instituto de Salud Musculoesquelética
  • ,
  • Annette de Thurah

OBJECTIVE: To analyse how non-adherence to prescribed treatments might be prevented, screened, assessed and managed in people with rheumatic and musculoskeletal diseases (RMDs). METHODS: An overview of systematic reviews (SR) was performed in four bibliographic databases. Research questions focused on: (1) effective interventions or strategies, (2) associated factors, (3) impact of shared decision making and effective communication, (4) practical things to prevent non-adherence, (5) effect of non-adherence on outcome, (6) screening and assessment tools and (7) responsible healthcare providers. The methodological quality of the reviews was assessed using AMSTAR-2. The qualitative synthesis focused on results and on the level of evidence attained from the studies included in the reviews. RESULTS: After reviewing 9908 titles, the overview included 38 SR on medication, 29 on non-pharmacological interventions and 28 on assessment. Content and quality of the included SR was very heterogeneous. The number of factors that may influence adherence exceed 700. Among 53 intervention studies, 54.7% showed a small statistically significant effect on adherence, and all three multicomponent interventions, including different modes of patient education and delivered by a variety of healthcare providers, showed a positive result in adherence to medication. No single assessment provided a comprehensive measure of adherence to either medication or exercise. CONCLUSIONS: The results underscore the complexity of non-adherence, its changing pattern and dependence on multi-level factors, the need to involve all stakeholders in all steps, the absence of a gold standard for screening and the requirement of multi-component interventions to manage it.

OriginalsprogEngelsk
Artikelnummere001432
TidsskriftRMD Open
Vol/bind6
Nummer3
Antal sider11
DOI
StatusUdgivet - nov. 2020

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