Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis

Jones, Mandy; Moffatt, Fiona; Harvey, Alex; Ryan, Jennifer M

doi:10.1002/14651858.cd013610.pub2

Cited by 3 publications

(1 citation statement)

References 91 publications

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“…There is a need to study adherence to CF therapies and formulate strategies to increase compliance and overcome the barriers. 14,15 Undoubtedly, public physiotherapy services for children and adolescents with CF in their municipality of residence is a low cost, simple, and fundamental strategy to overcome barriers and increase adherence.…”

Section: Discussionmentioning

confidence: 99%

Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis

Pereira Módolo,

Bergamim Uliana,

Mayrink Gonçalves Liberato

et al. 2024

jhgd

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Introduction: chest physiotherapy, airway clearance techniques, and physical exercise are associated with better outcomes in cystic fibrosis, but adherence to these recommendations remains a challenge. Objective: to assess adherence to chest physiotherapy, airway clearance techniques, and physical exercise by children and adolescents with cystic fibrosis and analyze the factors related to adherence. Methods: retrospective study of children and adolescents with cystic fibrosis from a pediatric referral center in Brazil. Data were collected from electronic records of the multidisciplinary team responsible for caring for these patients at the referral center. Results: the sample included all 83 patients registered at the referral center, with a mean age of 7.88 ± 4.88 years. Among them, 28.9% did not have weekly chest physiotherapy, 66.3% did not practice physical exercise regularly, and only 38.6% practiced airway clearance techniques from 6 to 7 times a week. Higher adherence to airway clearance techniques was associated with higher mean age (p<0.01) and correlated with FEV1 (r=-0.39; p=0.03), FEF25-75% (r =-0.36; p=0.02), FEV1/FVC (r =-0.43; p=0.01) and lower mean Shwachman-Kulczycki Score (r=-0.34; p<0.01). Higher physical exercise adherence was associated with a higher mean age (p<0.01). Individuals using public financing of physiotherapy services had a lower Shwachman-Kulczycki Score (p=0.02) than those using non-public services. The metropolitan region had a higher percentage of individuals using non-public services than other regions (p<0.01). Conclusion: adherence to chest physiotherapy, airway clearance techniques and physical exercise was lower than recommendations. Airway clearance techniques and physical exercise adherence increased with age, and airway clearance techniques adherence was associated with the high severity of disease. These results suggest that patients only increase adherence when they get older and the disease worsens, highlighting the need for strategies to increase adherence early.

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Section: Discussionmentioning

confidence: 99%

Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis

Pereira Módolo,

Bergamim Uliana,

Mayrink Gonçalves Liberato

et al. 2024

jhgd

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Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis

Jones

Moffatt

Harvey

et al. 2023

Cochrane Database of Systematic Reviews

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The Use of Mobile Health Technology and Behavioral Economics to Encourage Adherence to Statins and Blood Pressure Lowering Medication in Adolescents with Familial Hypercholesterolemia or Hypertension: Protocol for Pre-Post Comparison Study (Preprint)

Hartz,

Palfray,

de Ferranti

et al. 2024

Preprint

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BACKGROUND Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the United States, with risk factors such as hypertension and elevated LDL cholesterol originating in childhood. While statins and blood pressure-lowering medications can mitigate these risks, adherence is often poor, particularly among youth. Innovative solutions, such as monetary incentives via smartphone applications, may enhance adherence, but evidence in youth is lacking. OBJECTIVE This study aims to evaluate the efficacy of a smartphone application (Wellth®) offering financial incentives to improve adherence to statins and blood pressure-lowering medications among youth aged 12-19 at risk for cardiovascular disease. METHODS We initially designed a randomized controlled trial to compare the efficacy of two different incentive structures in youth treated with a statin for familial hypercholesterolemia with inadequate adherence. After facing recruitment challenges, the study protocol was changed to evaluating a single incentive in a pre-post design, The primary outcome was the change in adherence rate over the 60-day incentive period compared to the adherence rate during the 14-day “run-in” period. The secondary outcome was a change in LDL cholesterol level. Adjustments to the protocol were made in response to recruitment challenges during the COVID-19 pandemic, simplifying the incentive structure and expanding eligibility criteria. RESULTS The study is currently undergoing recruitment and collection of data from the first participants. The study has faced recruitment challenges exacerbated by the COVID-19 pandemic, necessitating protocol modifications. Detailed analysis of adherence rates and LDL cholesterol changes is ongoing. CONCLUSIONS This study explores the efficacy of monetary incentives delivered through a smartphone application to improve medication adherence in youth at risk for CVD. The findings will be used to build upon the existing literature in an effort to improve medication adherence throughout the life-course and ultimately reduce CVD.

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Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis

Cited by 3 publications

References 91 publications

Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis

Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis

Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis

The Use of Mobile Health Technology and Behavioral Economics to Encourage Adherence to Statins and Blood Pressure Lowering Medication in Adolescents with Familial Hypercholesterolemia or Hypertension: Protocol for Pre-Post Comparison Study (Preprint)

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