Improving medication adherence in chronic obstructive pulmonary disease: a systematic review

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Behavioral Science

Background:

• Suboptimal medication adherence in Chronic Obstructive Pulmonary Disease (COPD) negatively impacts patient survival and increases healthcare costs.
• Existing literature lacks a systematic review on the efficacy of interventions designed to enhance medication adherence in COPD patients.

Purpose of the Study:

• To systematically review and evaluate the effectiveness of interventions aimed at improving medication adherence among individuals diagnosed with COPD.

Main Methods:

• Searched electronic databases (Medline, Cochrane) using relevant MeSH terms and keywords.
• Included English-language studies focusing on interventions to improve COPD medication adherence.
• Assessed methodological quality using Effective Practice and Organisation of Care (EPOC) criteria.

Main Results:

• Seven studies met inclusion criteria from 1,186 identified papers, with variable methodological quality.
• Five studies reported effective interventions, including brief counseling, electronic monitoring feedback, and multi-component self-management/care coordination programs.
• Interventions involved pharmacists and primary care teams, demonstrating potential for improved adherence.

Conclusions:

• Brief counseling, electronic monitoring, and multi-component interventions show promise for improving COPD medication adherence.
• Further research with larger sample sizes and standardized adherence measures is needed to identify cost-effective strategies.
• Future interventions should consider involving caregivers and targeting both patients and healthcare providers.