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SYSTEMATIC REVIEW article

Front. Public Health
Sec. Public Health Education and Promotion
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1404590
This article is part of the Research Topic Behaviors, Bias, and Decision-Making in Health View all 13 articles

Nudge theories and strategies influencing adult health behaviors and outcomes in COPD management: a systematic review

Provisionally accepted
Qiuhui Wu Qiuhui Wu 1Ruobin Zhang Ruobin Zhang 1Li Tao Li Tao 2Wenting Cai Wenting Cai 1Xinrui Cao Xinrui Cao 3Zhi Mao Zhi Mao 4*Jinping Zhang Jinping Zhang 1*
  • 1 Department of Pharmacy, Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
  • 2 Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China
  • 3 Gansu Provincial Cancer Hospital, Lanzhou, Gansu Province, China
  • 4 Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, beijing, China

The final, formatted version of the article will be published soon.

    Objective: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence and mortality, and self-management is a key component for better outcomes of COPD. Recently, nudging has shown promising potential in COPD management. In the present study, we conducted a systematic review to collate the list of nudges and identified the variables that influence nudging. Methods: We undertook a systematic review. We employed database searches and snowballing. Data from selected studies were extracted. The risk of bias was assessed using the Cochrane Effective Practice and Organization of Care risk of bias tool. The study is registered with PROSPERO, CRD42023427051. Results: We retrieved 4,022 studies from database searches and 38 studies were included. By snowballing, 5 additional studies were obtained. Nudges were classified into four types: social influence, gamification, reminder, and feedback. Medication adherence, inhalation technique, physical activity, smoking cessation, vaccination administration, exercise capacity, self-efficacy, pulmonary function, clinical symptoms, and quality of life were analyzed as targeted health behaviors and outcomes. We found medication adherence was significantly improved by reminders via mobile applications or text materials, as well as feedback based on devices. Additionally, reminders through text materials greatly enhance inhalation techniques and vaccination in patients. Conclusions: This review demonstrates nudging can improve the health behaviors of patients with COPD and shows great potential for certain outcomes, particularly medication adherence, inhalation techniques, and vaccination. Additionally, the delivery modes, the patient characteristics, and the durations and seasons of interventions may influence the successful nudge-based intervention.

    Keywords: chronic obstructive pulmonary disease, Health Behavior, self-management, nudge, Systematic review

    Received: 21 Mar 2024; Accepted: 25 Oct 2024.

    Copyright: © 2024 Wu, Zhang, Tao, Cai, Cao, Mao and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Zhi Mao, Department of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, beijing, China
    Jinping Zhang, Department of Pharmacy, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.