Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: Systematic reviews informing the 2020 EULAR points to consider

Valentin Ritschl, Tanja A. Stamm*, Daniel Aletaha, Johannes W.J. Bijlsma, Peter Böhm, Razvan Dragoi, Emma Dures, Fernando Estévez-López, Laure Gossec, Annamaria Iagnocco, José B. Negrón, Michal Nudel, Andréa Marques, Ellen Moholt, Conni Skrubbeltrang, Bart Van Den Bemt, Kirsten Viktil, Marieke Voshaar, Loreto Carmona, Annette De Thurah

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Objective To analyse how non-adherence to prescribed treatments might be prevented, screened, assessed and managed in people with rheumatic and musculoskeletal diseases (RMDs). Methods An overview of systematic reviews (SR) was performed in four bibliographic databases. Research questions focused on: (1) effective interventions or strategies, (2) associated factors, (3) impact of shared decision making and effective communication, (4) practical things to prevent non-adherence, (5) effect of non-adherence on outcome, (6) screening and assessment tools and (7) responsible healthcare providers. The methodological quality of the reviews was assessed using AMSTAR-2. The qualitative synthesis focused on results and on the level of evidence attained from the studies included in the reviews. Results After reviewing 9908 titles, the overview included 38 SR on medication, 29 on non-pharmacological interventions and 28 on assessment. Content and quality of the included SR was very heterogeneous. The number of factors that may influence adherence exceed 700. Among 53 intervention studies, 54.7% showed a small statistically significant effect on adherence, and all three multicomponent interventions, including different modes of patient education and delivered by a variety of healthcare providers, showed a positive result in adherence to medication. No single assessment provided a comprehensive measure of adherence to either medication or exercise. Conclusions The results underscore the complexity of non-adherence, its changing pattern and dependence on multi-level factors, the need to involve all stakeholders in all steps, the absence of a gold standard for screening and the requirement of multi-component interventions to manage it.

Original languageEnglish
Article numbere001432
JournalRMD Open
Volume6
Issue number3
DOIs
Publication statusPublished - 7 Nov 2020

Keywords

  • Epidemiology
  • Health services research
  • Patient Care Team

Fingerprint

Dive into the research topics of 'Prevention, screening, assessing and managing of non-adherent behaviour in people with rheumatic and musculoskeletal diseases: Systematic reviews informing the 2020 EULAR points to consider'. Together they form a unique fingerprint.

Cite this