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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

Care models for patients with heart failure at home: A systematic review

Por: Xuetong Zhao · Shuang Wu · Nan Luo · Qiuxia Lin · Xinyi Zhao · Kun Li — Enero 5th 2024 at 07:14

Abstract

Aims

The aim of this study is to evaluate the relative merits of various heart failure models of care with regard to a variety of outcomes.

Design

Systematic review.

Data Sources

Five databases including PubMed, Web of Science, Medline, Embase and Science Direct were searched from the inception date of databases to August 20, 2022.

Review Methods

This review used the Cochrane Collaboration's ‘Risk of Bias’ tool to assess quality. Only randomised controlled trails were included in this review that assessed all care models in the management of adults with heart failure. A categorical summary of the pattern of the papers was found, followed by extraction of outcome indicators.

Results

Twenty articles (19 studies) were included. Seven examined nurse-led care, two examined multidisciplinary specialist care, nine (10 articles) examined patient self-management, and one examined nurse and physiotherapist co-led care. Regarding outcomes, this review examined how well the four models performed with regard to quality of life, health services use, HF self-care, and anxiety and depression for heart failure patients. The model of patient self-management showed more beneficial results than nurse-led care, multidisciplinary specialist care, and nurse and physiotherapist co-led care in reducing hospital days, improving symptoms, promoting self-care behaviours of HF patients, enhancing the quality of life, and strengthening self-care ability.

Conclusions

This systematic review synthesises the different care models and their relative effectiveness. Four different models of care were summarised. Of these models, the self-management model demonstrated better outcomes.

Impact

The self-management model is more effective in increasing self-management behaviours and self-management abilities, lowering the risk of hospitalisation and death, improving quality of life, and relieving anxiety and depression than other models.

No Patient or Public Contribution

There was no funding to remunerate a patient/member of the public for this review.

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