@article{81c0f5457865425489d1eae75b2cab8d,
title = "Features of successful interventions to improve adherence to Inhaled Corticosteroids in children with asthma: A narrative systematic review",
abstract = "INTRODUCTION: Nonadherence to inhaled corticosteroids (ICSs) 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 summarizes the efficacy and the characteristics of effective interventions.METHODS: Six databases were systematically searched on October 3, 2020 for randomized 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 National Institute for Health and Care Excellence guidelines for medicines adherence (the Perceptions and Practicalities Approach, PAPA) and behavior change techniques (BCTs), to determine the effective aspects of the intervention.RESULTS: Of 240 studies identified, 25 were eligible for inclusion. Thirteen of the 25 studies were categorized as being highly reliable. Nine of the 13 interventions were effective at increasing adherence and 6 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 nonadherence.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.",
keywords = "adherence, asthma, children, inhaled corticosteroids, intervention, systematic review, Reproducibility of Results, Adrenal Cortex Hormones/therapeutic use, Humans, Asthma/drug therapy, Child",
author = "Pearce, {Christina J} and Amy Chan and Tracy Jackson and Louise Fleming and Holly Foot and Andy Bush and Rob Horne",
note = "Funding Information: Christina J. Pearce, Tracy Jackson, and Andy Bush do not have any conflict of interests. Louise Fleming reports her conflict of interests as grants from Asthma UK and speakers fees or fees for expert consultation from Teva, AstraZeneca, Sanofi, Respiri, Novartis; all fees paid direct to her institution and outside the submitted work. Holly Foot is a freelance consultant for Spoonful of Sugar Ltd. Amy H. Y. Chan reports her conflict of interests as grants and consultancy fees from Janssen‐Cilag and from UCL‐Business spin‐out company Spoonful of Sugar Ltd; grants from Innovate UK, A+ charitable trust (Auckland District Health Board), Maurice and Phyllis Paykel trust, Universitas 21, NZ Pharmacy Education Research Fund, Auckland Academic Health Alliance, the University of Auckland, Health Research Council, Oakley Mental Health Foundation, outside the submitted work. Amy H. Y. Chan is also the recipient of the Robert Irwin Postdoctoral Fellowship. Rob Horne reports his conflict of interests as grants/research support AstraZeneca; National Institute for Health Research (NIHR), Collaboration for Leadership in Applied Health Research and Care (CLAHRC), North Thames at Bart's Health NHS Trust; Honoraria/consultation fees: AbbVie, Amgen, Astellas, AstraZeneca, Biogen, Erasmus, Idec, Gilead Sciences, GlaxoSmithKline, Janssen, Merck Sharp Dohme, Novartis, Pfizer, Roche, Shire Pharmaceuticals, and TEVA. Founder and shareholder of a UCL‐Business company (Spoonful of Sugar Ltd) providing consultancy on supporting patients with medicines and treatment‐related behaviors to healthcare policymakers, providers, and industry. Funding Information: We would first like to thank all our colleagues at the Asthma UK Centre for Applied Research, including the Patient and Public Involvement group, for choosing to fund this studentship. Christina J. Pearce would like to thank them also for the support given throughout her PhD for conference fees, hosting their annual conferences, and student webinars. Second, we would like to thank the library staff at the University College London, School of Pharmacy Library, for the personalized training and assistance in developing the search strategy and familiarization with databases. Funding was provided by Asthma UK via the Asthma UK Centre for Applied Research for a PhD studentship. Rob Horne is also funded by NIHR CLAHRC North Thames. Andy Bush is an NIHR Senior Investigator emeritus. Louise Fleming is an Asthma UK Senior Clinical Fellow. Funding Information: We would first?like to thank all our colleagues at the Asthma UK Centre for Applied Research, including the Patient and Public Involvement group, for choosing to fund this studentship. Christina J. Pearce would like to thank them also for the support given throughout her PhD for conference fees, hosting their annual conferences, and student webinars. Second, we would like to thank the library staff at the University College London, School of Pharmacy Library, for the personalized training and assistance in developing the search strategy and familiarization with databases.?Funding was provided by Asthma UK via the Asthma UK Centre for Applied Research for a PhD studentship. Rob Horne is also funded by NIHR CLAHRC North Thames. Andy Bush is an NIHR Senior Investigator emeritus. Louise Fleming is an Asthma UK Senior Clinical Fellow. Publisher Copyright: {\textcopyright} 2022 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC",
year = "2022",
month = apr,
day = "1",
doi = "10.1002/ppul.25838",
language = "English",
volume = "57",
pages = "822--847",
journal = "Pediatric Pulmonology",
issn = "8755-6863",
publisher = "Wiley-Liss Inc.",
number = "4",
}