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Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Identifying determinants of varenicline adherence using the Theoretical Domains framework: a rapid review

Authors: Nadia Minian, Melissa Wong, Sowsan Hafuth, Terri Rodak, Alma Rahimi, Dea Gjomema, Jonathan Rose, Laurie Zawertailo, Matt Ratto, Peter Selby

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Adhering to varenicline has been shown to significantly improve the chances of successfully quitting smoking, with studies indicating a twofold increase in 6-month quit rates. However, despite its potential benefits, many individuals struggle with maintaining good adherence to varenicline; thus there is a need to develop scalable strategies to help people adhere. As a first step to inform the development of an intervention to improve adherence to varenicline, we conducted a rapid literature review to identify: 1) modifiable barriers and facilitators to varenicline adherence, and 2) behaviour change techniques associated with increased adherence to varenicline.

Methods

We searched MEDLINE, Embase, APA PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials for relevant studies published between 2006 and 2022. Search terms included “varenicline,” “smoking cessation,” and "adherence," and their respective subject headings and synonyms. We screened and included studies reporting modifiable determinants of adherence to varenicline and then assessed quality, extracted modifiable determinants and mapped them to the Theoretical Domains Framework version 2 and the Behaviour Change Technique Taxonomy version 1.

Results

A total of 1,221 titles were identified through the database searches; 61 met the eligibility criteria. Most of the studies were randomized controlled trials and predominantly focused on barriers to varenicline. Only nine studies explicitly mentioned behaviour change techniques used to help varenicline adherence. Eight domains were identified as barriers to varenicline adherence (behavioural regulation, memory, goals, intentions, beliefs about capabilities, beliefs about consequences, optimism/pessimism, and environmental context) and five as facilitators (knowledge, behavioural regulation, beliefs about capabilities, social influences, and environmental context).

Conclusions

This study identifies barriers and facilitators that should be addressed when developing a complex adherence intervention tailored to patients’ needs based on modifiable determinants of medication adherence, some of which are under- used by existing adherence interventions. The findings from this review will inform the design of a theory-based healthbot planned to improve varenicline adherence in people undergoing smoking cessation treatment.

Systematic review registration

This study was registered with PROSPERO (# CRD42022321838).
Appendix
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Metadata
Title
Identifying determinants of varenicline adherence using the Theoretical Domains framework: a rapid review
Authors
Nadia Minian
Melissa Wong
Sowsan Hafuth
Terri Rodak
Alma Rahimi
Dea Gjomema
Jonathan Rose
Laurie Zawertailo
Matt Ratto
Peter Selby
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18139-z

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