Project deliverable Open Access


Livitckaia Kristina

Ioanna Chouvarda

Thesis supervisor(s)

Ioanna Chouvarda; Mark van Gils; Evelyn Kouidi; Vasilis Koutkias; Nicos Maglaveras

This literature review on compliance/lifestyle change factors has been conducted within the Connected Health Early Stage Researcher Support System (CHESS) project; under the framework of Marie Skłodowska-Curie grant agreement NO. 676201 for the Work package 2.

The problem of patient compliance is becoming one of the most alarming in the medical practice worldwide. Studies showed that the low level of compliance is widely spread among patients with various diseases; yet, patients with chronic diseases are in the critical position due to the need to follow recommendation for a longer period of time, and very often - lifelong. Formation of patient compliance depends on many factors, including physician’s personality and style of medical practice, organization of health care and availability of certain facilities, particular aspects of a medicinal therapy regimen, socio - economic circumstances, personal and psychological characteristics of a patient, etc. However, in most cases, patients with different chronic diseases are considered to be different subjects from the perspective of factors affecting their adherence. Therefore, there is a need for a separate investigation of different groups of patients (e.g., patients with human immunodeficiency virus (HIV), patients with heart disease, etc.). Narrowing, there is limited data on patient adherence to a particular lifestyle change recommendation and its regimens, including maintenance of physical activity and physical fitness, following a balanced diet, etc. Considering physical activity and exercise as an essential part of lifestyle to control heart disease and prevent its further progression, this review focuses on a literature review of the influence factors associated with physical-activity-related adherence modification in a group of patients with heart disease.
Objectives: The objectives of the review include (A) identification of particular types of physical-activity-related behaviour and its settings in regard to adherence in patients with heart disease, (B) assembling adherence measurement criteria, (C) examination and classification of factors affecting adherence, and (D) analysis of adherence change power of specific programs, interventions, and its components based on the selected literature.
Methods: A comprehensive literature review was conducted based on the Arksey and O'Malley methodological framework. The procedure included identification of the literature review scope and research questions, establishment of the criteria for the relevance, study selection, charting the materials, and collating, summarizing, and reporting the results. When it was applicable, the systematic review approach methods were used in order to narrow and increase the quality of the final results. To complete the literature review, sources were accessed between March and August 2016.
Results: Outlined in the review results, a basis and key findings are highlighted for the development of the diagnostic algorithms to predict the adherence to a particular physical-activity-related behaviour of patients with heart disease. Addressed physical-activity-related behaviour is narrowed with regard to lifestyle physical activity and exercise regimen, or physical fitness. The interpretations of the results considered in the review, along with measurement criteria, and context of each of the behaviour, together with provided variety of associated factors and their complex relations to physical-activity-related adherence, allow to optimize patient assessment approaches, and as a result intervention strategies, through recommendations and rehabilitation programs tailoring for lifestyle change and adherence modification.

The deliverable was reviewed by Ioanna Chouvarda, AUTH and Vassilis Koutkias, CERTH.
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