Evidence map›Paper›PMID 39304207›Full record

SynthesisBMJ open respiratory research2024

Medication adherence to inhalation therapy and the risk of COPD exacerbations: a systematic review with meta-analysis.

Delphine Vauterin, Frauke Van Vaerenbergh, Maxim Grymonprez, Anna Vanoverschelde, Lies Lahousse

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  13. Observational
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  18. Proactive Strategies for Mitigating Cardiopulmonary Risk in COPD.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025
    Article
  19. COPD and Schizophrenia.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Delphine VauterinFaculty of Pharmaceutical Sciences, Department of Bioanalysis, Ghent University, Ghent, Belgium.ORCID 0000-0002-8932-476X
Frauke Van VaerenberghFaculty of Pharmaceutical Sciences, Department of Bioanalysis, Ghent University, Ghent, Belgium.
Maxim GrymonprezFaculty of Pharmaceutical Sciences, Department of Bioanalysis, Ghent University, Ghent, Belgium.
Anna VanoverscheldeFaculty of Pharmaceutical Sciences, Department of Bioanalysis, Ghent University, Ghent, Belgium.ORCID 0000-0002-5902-917X
Lies LahousseFaculty of Pharmaceutical Sciences, Department of Bioanalysis, Ghent University, Ghent, Belgium lies.lahousse@ugent.be.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAssessing medication adherence is crucial in chronic obstructive pulmonary disease (COPD) management to prevent exacerbations. However, it is unclear whether this association between adherence and exacerbations is influenced by the adherence assessment methods or thresholds used. Electronic healthcare databases are valuable to study exacerbations and adherence in real life. We aimed to systematically review the literature to identify adherence assessment methods and thresholds used in healthcare databases when investigating the association between medication adherence and COPD exacerbations and to meta-analyse the associated effect sizes.

methodMEDLINE, Web of Science and Embase were searched for peer-reviewed articles, written in English, published up to 10 October 2022 (PROSPERO: CRD42022363449). Two reviewers independently conducted screening for inclusion and performed data extraction. A qualitative approach described the adherence assessment methods and thresholds used. A quantitative approach (meta-analysis using random effects model) estimated the association between adherence and the risk of COPD exacerbations.

resultsEight studies were included in the systematic review of which five studies were included in the meta-analysis. The medication possession ratio (MPR) and the proportion of days covered (PDC) were the adherence assessment methods used and 0.80 was always used as threshold to differentiate good from poor adherence. Adherence and exacerbations were mostly measured over the same time period. Poor adherence (MPR or PDC<0.80) was significantly associated with a higher COPD exacerbation risk (OR 1.40, 95% CI 1.21 to 1.62, I

conclusionOur systematic review with meta-analysis demonstrated a 40% increased risk of COPD exacerbations in case of poor adherence to inhaler medication. PROSPERO REGISTRATION NUMBER: CRD42022363449.

Indexed as

Disease ProgressionDrug MonitoringPulmonary Disease, Chronic ObstructiveAdministration, InhalationHumansCOPD epidemiologyCOPD ExacerbationsCOPD Pharmacology

Identifiers

PMID39304207
PMCPMC11418573

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.