Delphine Vauterin, Frauke Van Vaerenbergh, Anna Vanoverschelde, Jennifer K Quint, Katia Verhamme, Lies Lahousse
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引用次数: 0
Abstract
Background: The Global Initiative for Chronic Obstructive Lung Disease 2023 report recommends medication adherence assessment in COPD as an action item. Healthcare databases provide opportunities for objective assessments; however, multiple methods exist. We aimed to systematically review the literature to describe existing methods to assess adherence in COPD in healthcare databases and to evaluate the reporting of influencing variables.
Method: We searched MEDLINE, Web of Science and Embase for peer-reviewed articles evaluating adherence to COPD medication in electronic databases, written in English, published up to 11 October 2022 (PROSPERO identifier CRD42022363449). Two reviewers independently conducted screening for inclusion and performed data extraction. Methods to assess initiation (dispensing of medication after prescribing), implementation (extent of use over a specific time period) and/or persistence (time from initiation to discontinuation) were listed descriptively. Each included study was evaluated for reporting variables with an impact on adherence assessment: inpatient stays, drug substitution, dose switching and early refills.
Results: 160 studies were included, of which four assessed initiation, 135 implementation and 45 persistence. Overall, one method was used to measure initiation, 43 methods for implementation and seven methods for persistence. Most of the included implementation studies reported medication possession ratio, proportion of days covered and/or an alteration of these methods. Only 11% of the included studies mentioned the potential impact of the evaluated variables.
Conclusion: Variations in adherence assessment methods are common. Attention to transparency, reporting of variables with an impact on adherence assessment and rationale for choosing an adherence cut-off or treatment gap is recommended.
背景:2023年全球慢性阻塞性肺病倡议报告建议将COPD的药物依从性评估作为一项行动项目。医疗保健数据库为客观评估提供了机会;然而,存在多种方法。我们旨在系统地回顾文献,以描述医疗数据库中评估COPD依从性的现有方法,并评估影响变量的报告。方法:我们在MEDLINE、Web of Science和Embase上搜索了截至2022年10月11日发表的以英文撰写的电子数据库中评估COPD药物依从性的同行评审文章(PROSPERO标识符CRD42022363449)。两名评审员分别进行了入选筛选和数据提取。描述性地列出了评估开始(处方后配药)、实施(特定时间段内的使用程度)和/或持续性(从开始到停药的时间)的方法。对每项纳入的研究都进行了评估,以报告对依从性评估有影响的变量:住院时间、药物替代、剂量转换和早期补充。结果:纳入160项研究,其中4项评估了启动情况,135项评估了实施情况,45项评估了持续性。总体而言,一种方法用于衡量启动,43种方法用于实施,7种方法用于持久性。大多数纳入的实施研究报告了药物持有率、覆盖天数比例和/或这些方法的改变。只有11%的纳入研究提到了评估变量的潜在影响。结论:依从性评估方法的变化是常见的。建议注意透明度,报告对依从性评估有影响的变量,以及选择依从性截止值或治疗间隔的理由。
期刊介绍:
The European Respiratory Review (ERR) is an open-access journal published by the European Respiratory Society (ERS), serving as a vital resource for respiratory professionals by delivering updates on medicine, science, and surgery in the field. ERR features state-of-the-art review articles, editorials, correspondence, and summaries of recent research findings and studies covering a wide range of topics including COPD, asthma, pulmonary hypertension, interstitial lung disease, lung cancer, tuberculosis, and pulmonary infections. Articles are published continuously and compiled into quarterly issues within a single annual volume.