Effectiveness of interventions targeting self-regulation to improve adherence to chronic disease medications: a meta-review of meta-analyses.
Effectiveness of interventions targeting self-regulation to improve adherence to chronic disease medications: a meta-review of meta-analyses.
复制标题
以自我调节为目标的干预措施的有效性，以提高慢性病药物的依从性：荟萃分析的荟萃回顾。
DOI：
10.1080/17437199.2019.1706615
复制
发表时间：
2020
影响因子：
9.8
通讯作者：
Birk,JeffreyL
中科院分区：
文献类型：
--
作者：
Wilson,TraceyE;Hennessy,EmilyA;Falzon,Louise;Boyd,Rebekah;Kronish,IanM;Birk,JeffreyL
慢性病药物治疗方案的依从性部分取决于成功的自我调节。然而，针对自我调节机制的干预措施的总体效益还没有得到很好的理解。因此，我们进行了一项荟萃分析的荟萃审查，评估针对自我调节的干预措施对药物依从性的影响。对于这项荟萃审查，2006年1月至2019年3月期间出现的荟萃分析符合条件，如果它们包括评估针对自我调节的干预措施对慢性病药物依从性的影响的实验性试验。在多个数据库中对已发表和未发表文献进行系统性文献检索，识别出16，001篇摘要。12项荟萃分析符合合格性标准，根据AMSTAR 2项目完成情况（M= 50%;范围：31-66%），质量存在差异。总体而言，荟萃评价显示，针对自我监测、提供依从性个性化反馈或涉及完全自我管理的干预措施的效应量较小至中等。其他干预措施，如目标设定，障碍识别和解决问题，以及压力管理，几乎没有证据表明提高依从性。只有数量有限的自我调节干预组件能够进行评估。需要进行更多的研究，通过扩大目标自我调节要素的范围（例如，情绪调节）。
Adherence to chronic disease medication regimens depends in part on successful self-regulation. However, the overall benefit of interventions targeting self-regulatory mechanisms is not well-understood. Accordingly, we conducted a meta-review of meta-analyses assessing the effect of interventions targeting self-regulation on medication adherence. For this meta-review, meta-analyses appearing between January 2006 and March 2019 were eligible if they included experimental trials that assessed the effect of an intervention targeting self-regulation on adherence to chronic disease medication. A systematic literature search of multiple databases for published and unpublished literature identified 16,001 abstracts. Twelve meta-analyses met eligibility criteria and had variable quality according to AMSTAR 2 item completion (M= 50%; range: 31–66%). Overall, meta-reviews showed small to medium effect sizes for interventions that targeted self-monitoring, provided personalised feedback on adherence, or involved complete self-management. Other interventions, such as goal setting, barrier identification and problem solving, and stress management showed little evidence of improving adherence. Only a limited number of self-regulation intervention components were able to be evaluated. Additional research is needed to advance the understanding of the efficacy of adherence interventions focussed on self-regulation by expanding the scope of self-regulation elements targeted (e.g., emotion regulation).