Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis

BackgroundAdherence to treatment, including inhaled therapies, is low in people with cystic fibrosis (CF). Although psychological interventions forimproving adherence to inhaled therapies in people with CF have been developed, no previous published systematic review has evaluatedthe evidence for efficacy of these interventions.ObjectivesThe primary objective of the review was to assess the efficacy of psychological interventions for improving adherence to inhaled therapiesin people with cystic fibrosis (CF). The secondary objective was to establish the most effective components, or behaviour changetechniques (BCTs), used in these interventions.Search methodsWe searched the Cochrane Cystic Fibrosis Trials Register, which is compiled from electronic database searches and handsearching ofjournals and conference abstract books.We also searched databases (PubMed; PsycINFO; EBSCO; Scopus; OpenGrey), trials registries (World Health Organization InternationalClinical Trials Registry Platform; US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov), and the reference lists ofrelevant articles and reviews, with no restrictions on language, year or publication status.Date of search: 7 August 2022.Selection criteriaWe included randomised controlled trials (RCTs) comparing different types of psychological interventions for improving adherence toinhaled therapies in people with CF of any age, or comparing psychological interventions with usual care. We included quasi-RCTs if wecould reasonably assume that the baseline characteristics were similar in both groups.Data collection and analysisTwo review authors independently assessed trial eligibility and completed data extraction, risk of bias assessments, and BCT coding (usingthe BCT Taxonomy v1) for all included trials. We resolved any discrepancies by discussion, or by consultation with a third review author asnecessary. We assessed the certainty of the evidence using GRADE.