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☐ ☆ ✇ Journal of Clinical Nursing

Prediction Models of Medication Adherence in Chronic Disease Patients: Systematic Review and Critical Appraisal

Por: Jingwen Xu · Xinyi Zhao · Fei Li · Yan Xiao · Kun Li — Diciembre 31st 2024 at 06:14

ABSTRACT

Aims and Objectives

To summarise the currently developed risk prediction models for medication adherence in patients with chronic diseases and evaluate their performance and applicability.

Background

Ensuring medication adherence is crucial in effectively managing chronic diseases. Although numerous studies have endeavoured to construct risk prediction models for predicting medication adherence in patients with chronic illnesses, the reliability and practicality of these models remain uncertain.

Design

Systematic review.

Methods

We conducted searches on PubMed, Web of Science, Cochrane, CINAHL, Embase and Medline from inception until 16 July 2023. Two authors independently screened risk prediction models for medication adherence that met the predefined inclusion criteria. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to evaluate both the risk of bias and clinical applicability of the included studies. This systematic review adhered to the 2020 PRISMA checklist.

Results

The study included a total of 11 risk prediction models from 11 studies. Medication regimen and age were the most common predictors. The use of PROBAST revealed that some essential methodological details were not thoroughly reported in these models. Due to limitations in methodology, all models were rated as having a high-risk for bias.

Conclusions

According to PROBAST, the current models for predicting medication adherence in patients with chronic diseases exhibit a high risk of bias. Future research should prioritise enhancing the methodological quality of model development and conducting external validations on existing models.

Relevance to Clinical Practice

Based on the review findings, recommendations have been provided to refine the construction methodology of prediction models with an aim of identifying high-risk individuals and key factors associated with low medication adherence in chronic diseases.

Patient or Public Contribution

This systematic review was conducted without patient or public participation.

☐ ☆ ✇ Journal of Clinical Nursing

Analysis of Factors Related to Physical Activity Levels Among Lung Cancer Survivors Who Underwent Nonsurgical Treatment: A Cross‐Sectional Study

Por: Qiaoqiao Ma · Jing Luo · Xiaoqing Liu · Huxing Cao · Shengchang Ye · Nan Dang · Ting Wang · Jianfei Li · Shajing Fan · Lili Hou — Septiembre 20th 2024 at 13:19

ABSTRACT

Aim(s)

The study aimed to investigate the current status of physical activity (PA) levels and associated factors among lung cancer survivors who have undergone nonsurgical treatments.

Background

PA has been incorporated as a nonpharmacological intervention in the rehabilitation programmes of cancer patients, playing a crucial role in alleviating symptom burden and enhancing the quality of life among lung cancer survivors. Understanding the potential influencing factors of PA levels aids in formulating targeted intervention strategies.

Design

A multicentre cross-sectional study.

Methods

Convenience sampling was utilised to survey lung cancer survivors from the respiratory and oncology departments of 12 hospitals across Eastern, Central and Western China, spanning from June 2023 to January 2024. Social demographic characteristics, disease-related features, health behaviour abilities, psychological factors and levels of PA were collected through a combination of clinical case systems used to record patients' treatment and medical conditions and self-reported questionnaires. Additionally, measurements of grip strength and the 6-min walk test were conducted for patients. Descriptive analysis, bivariate analysis and multivariate logistic regression were conducted.

Results

Only 109 patients (16.2%) achieved high PA levels. Multivariate logistic regression analysis indicated differences in age, residential location, employment status, religion, lung cancer stage, grip strength, albumin concentration, blood urea, Anderson symptom, depression and health behaviour capacity among lung cancer survivors with varying PA levels.

Conclusions

Significant associations were observed between age ≥ 75 years, residing in urban areas, unemployment, absence of religious beliefs, Stage IV lung cancer, lower grip strength, lower albumin concentration, higher blood urea, higher Anderson symptom scores, lower health behaviour capacity scores, higher depression scores and lower PA levels among lung cancer survivors. These potential factors should be considered when developing PA intervention plans.

Relevance to Clinical Practice

This study offers insights for developing subsequent PA intervention programmes. In clinical practice, healthcare professionals should continuously educate patients about the benefits of exercise and help them incorporate PA into their daily lives. Additionally, emphasising multidisciplinary collaboration involving physical therapists, nutritionists and mental health experts is crucial for ensuring safe and effective PA, thereby improving patients' quality of life.

Reporting Method

Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross-sectional studies.

Patient or Public Contribution

At the phase of collecting data, participants were recruited to fill the questionnaires.

Trial Registration

Chinese Clinical Trial Registry: ChiCTR2300072609

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