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Interventions to improve adherence in children with asthma: A systematic review
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  • Christina Pearce,
  • Amy Chan,
  • Tracy Jackson,
  • Louise Fleming,
  • Holly Foot,
  • Andrew Bush,
  • Robert Horne
Christina Pearce
University College London

Corresponding Author:[email protected]

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Amy Chan
University College London
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Tracy Jackson
The University of Edinburgh
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Louise Fleming
Royal Brompton and Harefield NHS Foundation Trust
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Holly Foot
The University of Auckland
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Andrew Bush
Imperial College London
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Robert Horne
University College London
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Introduction: Non-adherence to inhaled corticosteroids (ICS) in children with asthma leads to significant morbidity and mortality. Few interventions to improve adherence have been effective and little is known about what contributes to intervention effectiveness. This systematic review summarises the efficacy of these interventions and the characteristics of effective interventions to inform future studies aiming to improve adherence to ICS in children with asthma. Methods: PubMed, Embase, PsychINFO, Medline, Web of Science, and International Pharmaceutical Abstracts were systematically searched on the 3rd of October 2020 for randomised control trials measuring adherence to ICS in children with asthma. A narrative synthesis was conducted focusing on intervention efficacy and study reliability. Intervention content was coded based on the NICE guidelines for medicines adherence (The Perceptions and Practicalities Approach, PAPA) and Behaviour Change Techniques (BCT), to determine the effective aspects of the intervention. Results: Of 240 studies identified, 25 were eligible for inclusion. Thirteen of the twenty-five studies were categorised as being highly reliable. Nine of the thirteen studies were effective at increasing adherence and six of those met the criteria for a PAPA intervention. Conclusion: Adherence interventions in children with asthma have mixed effectiveness. Effective studies tended to be of higher quality, were tailored to individuals perceptual and practical adherence barriers, and used multiple BCTs. However, due to the small number of included studies and varying study design quality, conclusions drawn here are preliminary. Future research is needed to test a PAPA-based intervention with a rigorous study design as outlined in this review
29 Sep 2021Submitted to Pediatric Pulmonology
30 Sep 2021Submission Checks Completed
30 Sep 2021Assigned to Editor
05 Oct 2021Reviewer(s) Assigned
11 Nov 2021Review(s) Completed, Editorial Evaluation Pending
12 Nov 2021Editorial Decision: Revise Minor
10 Jan 20221st Revision Received
11 Jan 2022Submission Checks Completed
11 Jan 2022Assigned to Editor
11 Jan 2022Reviewer(s) Assigned
18 Jan 2022Review(s) Completed, Editorial Evaluation Pending
18 Jan 2022Editorial Decision: Accept