Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
复制标题
DOI：
10.1186/s13643-016-0255-z
复制
发表时间：
2016-05-04
影响因子：
3.7
通讯作者：
Jacobs S
中科院分区：
文献类型：
--
作者：
Kahwati L;Viswanathan M;Golin CE;Kane H;Lewis M;Jacobs S
改善药物依从性的干预措施多种多样且复杂。因此，综合这些证据具有挑战性。我们的目的是扩展现有的干预措施的系统评价的结果，以提高药物治疗依从性，通过使用定性比较分析（QCA），以确定必要的或足够的配置行为改变技术之间的有效干预措施。我们在一项完整的系统综述中使用了60项研究的数据，以检查9种行为改变技术（增加知识，增加意识，改变态度，增加自我效能，增加意图形成，增加行动控制，促进，增加维护支持和动机访谈）的组合，这些研究表明依从性有所改善。在60项研究中，34项研究显示药物依从性改善。在有效的研究中，增加患者知识是必要的，但不是足够的技术。我们确定了七种足以提高依从性的行为改变技术配置，这些配置共占26项（76%）有效研究。包括增加知识和自我效能的干预配置是最具经验相关性的，占17项研究（50%）和15项（44%）。该分析通过识别提高依从性的行为改变技术的多种组合来扩展已完成的审查结果。我们的研究结果为政策制定者，从业者和未来的比较有效性研究提供了方向，以提高依从性。本文的在线版本（doi：10.1186/s13643-016-0255-z）包含补充材料，可供授权用户使用。
Interventions to improve medication adherence are diverse and complex. Consequently, synthesizing this evidence is challenging. We aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. We used data from 60 studies in a completed systematic review to examine the combinations of nine behavior change techniques (increasing knowledge, increasing awareness, changing attitude, increasing self-efficacy, increasing intention formation, increasing action control, facilitation, increasing maintenance support, and motivational interviewing) among studies demonstrating improvements in adherence. Among the 60 studies, 34 demonstrated improved medication adherence. Among effective studies, increasing patient knowledge was a necessary but not sufficient technique. We identified seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 %) of the effective studies. The intervention configuration that included increasing knowledge and self-efficacy was the most empirically relevant, accounting for 17 studies (50 %) and uniquely accounting for 15 (44 %). This analysis extends the completed review findings by identifying multiple combinations of behavior change techniques that improve adherence. Our findings offer direction for policy makers, practitioners, and future comparative effectiveness research on improving adherence. The online version of this article (doi:10.1186/s13643-016-0255-z) contains supplementary material, which is available to authorized users.