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Article
Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review
Respiratory Medicine
  • Amanda McCullough, Bond University
  • Cristin Ryan, Royal College of Surgeons in Ireland
  • Christopher Macindoe, Bond University
  • Nathan Yii, Bond University
  • Judy Bradley, Queens University -Belfast
  • Brenda O'Neill, Ulster University, Jordanstown, UK
  • Stuart Elborn, Queen's University Belfast
  • Carmel Hughes, Queen's University Belfast
Date of this Version
7-1-2016
Document Type
Journal Article
Grant Number
NHMRC grant number 1044904
Publication Details

Citation only

McCullough, A. R., Ryan, C., Macindoe, C., Yii, N., Bradley, J. M., O'Neill, B., Elborn, S., Hughes, C. M. (2016). Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review. Respiratory Medicine, 116, 78-84.

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© 2016 Elsevier Ltd. All rights reserved.

Abstract
Background We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease. Methods We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content (grouped into psychological, education and self-management/supportive, telemonitoring, shared decision-making); and delivery. "Effective" studies were those with p < 0.05 for adherence rate between groups. We conducted a narrative synthesis and assessed risk of bias. Results 12,488 articles screened; 46 included studies (n = 42,91% in OSA or asthma) testing 58 interventions (n = 27, 47% were effective). Nineteen (33%) interventions (15 studies) used 12 different behavior change theories. Use of theory (n = 11,41%) was more common amongst effective interventions. Interventions were mainly educational, self-management or supportive interventions (n = 27,47%). They were commonly delivered by a doctor (n = 20,23%), in face-to-face (n = 48,70%), one-to-one (n = 45,78%) outpatient settings (n = 46,79%) across 2-5 sessions (n = 26,45%) for 1-3 months (n = 26,45%). Doctors delivered a lower proportion (n = 7,18% vs n = 13,28%) and pharmacists (n = 6,15% vs n = 1,2%) a higher proportion of effective than ineffective interventions. Risk of bias was high in >1 domain (n = 43, 93%) in most studies. Conclusions Behavior change theory was more commonly used to design effective interventions. Few adherence interventions have been developed using theory, representing a gap between intervention design recommendations and research practice
Citation Information
Amanda McCullough, Cristin Ryan, Christopher Macindoe, Nathan Yii, et al.. "Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review" Respiratory Medicine Vol. 116 (2016) p. 78 - 84 ISSN: 0954-6111
Available at: http://works.bepress.com/amanda_mccullough/15/