Interventions for improving treatment adherence in young people with inflammatory bowel disease (IBD): A systematic review of behaviour change theory and behaviour change techniques

TL;DR

This study reviews interventions to help young people with inflammatory bowel disease stick to their treatments, focusing on behavior change techniques and theories.

Contribution

The study is the first to systematically review behavior change theory and techniques in interventions targeting treatment adherence in young IBD patients.

Findings

Seven interventions focused on oral medication adherence in young IBD patients.

Interventions involving family members or tailored support showed better results.

Poor reporting limits clear conclusions about intervention effectiveness.

Abstract

Treatment adherence is important but challenging for young people with inflammatory bowel disease (IBD). Behavioural interventions may support adherence, leading to improved condition management. This review aimed to evaluate interventions designed to improve treatment adherence in young people (aged 13–18) with IBD and identify their use of behaviour change theory and behaviour change techniques (BCTs). Five databases (PsycInfo, Embase, MEDLINE, Web of Science and Scopus) were searched to identify eligible articles published between 1980 and 2022. Articles were critically appraised using the Mixed Methods Appraisal Tool. Findings were synthesised narratively. Seven articles reporting seven oral medication adherence interventions were included. Study designs included five randomised controlled trials and two single-arm clinical trials. Eleven BCTs were identified across seven articles. No article discussed how an intervention was informed by behaviour change theory. Interventions that included additional family members and/or offered tailored adherence support generally had greater effects, as did interventions including education and goal setting components. Reporting of intervention content was poor, limiting our ability to make concrete recommendations regarding intervention effectiveness, use of behaviour change theory and BCTs. Further research is needed to understand how theory-driven behaviour change interventions can improve treatment adherence in young people with IBD.

Figures