COPD-patients’ perspective on adherence to therapy and its integration into a systematic literature review

OBJECTIVE: Patient involvement in scientific research is becoming increasingly important to ensure a patient-centered approach to medicine. The objective of this study is twofold: firstly, to ascertain patients’ perspectives on adherence to therapy and secondly, to integrate this information into a systematic review (SR) on interventions to improve adherence in chronic obstructive pulmonary disease (COPD). METHODS: In parallel with the SR, two focus group interviews with a COPD self-help group were conducted using semi-structured interview guidelines. The interviews were analyzed using computer-assisted qualitative content analysis according to Kuckartz with the aim of complementing the results of the systematic literature review and to develop propositions for further scientific use. RESULTS: The first focus group interview comprising 321 codes included 14 (mean age 67.7 ± 6.8 years; 71.4% female) and the second interview comprising 139 codes included 10 (mean age 68,5 ± 8,2 years; 50% female) patients. Ten categories of the content analysis informed the logic models and the applicability analysis of the SR and six propositions representing the patient’s perspective were developed for further scientific use: Main themes were (I) Enhancement of patient’s self-efficacy (II) Access to trusted medical information (III) Patient-physician relationship (IV) Measures to improve adherence (V) Sociocultural/medical environment (VI) Methods to measure adherence. CONCLUSION: The inclusion of the patient perspective in an SR can be successfully achieved by conducting focus group interviews. Multimodal measures aimed at enhancing patient’s self-efficacy helping them to achieve individual goals reinforces adherence to therapy from a patient’s perspective.