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Interventions for improving treatment adherence in young people with inflammatory bowel disease (IBD): A systematic
Cassandra Screti1, Lou Atkinson1, Rachel Shaw1
1School of Health and Life Sciences, Aston University, Birmingham, UK.
Insights
Improving treatment adherence for adolescents with inflammatory bowel disease (IBD) is key. Interventions involving family and tailored support, education, and goal setting showed promise, though theory-driven approaches need further investigation.
Area of Science:
- Pediatric Gastroenterology
- Behavioral Science
- Health Psychology
Background:
- Treatment adherence is a significant challenge for young patients with inflammatory bowel disease (IBD).
- Behavioral interventions offer a potential pathway to enhance adherence and improve disease management in this population.
- Understanding the theoretical underpinnings and specific techniques used in these interventions is crucial for optimizing their effectiveness.
Purpose of the Study:
- To evaluate interventions aimed at improving treatment adherence in adolescents (13-18 years) diagnosed with IBD.
- To identify the specific behavior change techniques (BCTs) employed within these interventions.
- To assess the extent to which interventions were informed by established behavior change theories.
Main Methods:
- A systematic literature search was conducted across five major databases (PsycInfo, Embase, MEDLINE, Web of Science, Scopus) for articles published between 1980 and 2022.
- Seven articles detailing seven oral medication adherence interventions for young people with IBD were included.
- Interventions were critically appraised using the Mixed Methods Appraisal Tool, and findings were synthesized through narrative review.
Main Results:
- Eleven distinct BCTs were identified across the seven included interventions.
- Interventions incorporating family members, tailored support, education, and goal-setting components demonstrated generally greater positive effects on adherence.
- A significant gap was noted as no study explicitly discussed the use of behavior change theory to inform intervention design.
Conclusions:
- While interventions using BCTs like education and goal setting show potential for improving IBD treatment adherence in adolescents, their effectiveness is limited by poor reporting of intervention details.
- There is a critical need for future research to develop and evaluate theory-driven behavioral interventions to enhance medication adherence in young people with IBD.
- Future interventions should clearly articulate the theoretical framework and specific BCTs utilized to allow for robust evaluation and replication.
Abstract:
Treatment adherence is important but challenging for young people with inflammatory bowel disease (IBD). Behavioural interventions may support adherence, leading to improved condition management. This review aimed to evaluate interventions designed to improve treatment adherence in young people (aged 13-18) with IBD and identify their use of behaviour change theory and behaviour change techniques (BCTs). Five databases (PsycInfo, Embase, MEDLINE, Web of Science and Scopus) were searched to identify eligible articles published between 1980 and 2022. Articles were critically appraised using the Mixed Methods Appraisal Tool. Findings were synthesised narratively. Seven articles reporting seven oral medication adherence interventions were included. Study designs included five randomised controlled trials and two single-arm clinical trials. Eleven BCTs were identified across seven articles. No article discussed how an intervention was informed by behaviour change theory. Interventions that included additional family members and/or offered tailored adherence support generally had greater effects, as did interventions including education and goal setting components. Reporting of intervention content was poor, limiting our ability to make concrete recommendations regarding intervention effectiveness, use of behaviour change theory and BCTs. Further research is needed to understand how theory-driven behaviour change interventions can improve treatment adherence in young people with IBD.
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