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Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model

Author

Listed:
  • Amanual Getnet Mersha

    (School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia)

  • Gillian Sandra Gould

    (School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
    Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia)

  • Michelle Bovill

    (School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
    Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia)

  • Parivash Eftekhari

    (School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
    Hunter Medical Research Institute, Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia)

Abstract

Background: Poor adherence to nicotine replacement therapy (NRT) is associated with low rates of smoking cessation. Hence, this study aims to identify and map patient-related factors associated with adherence to NRT using the capability, opportunity, motivation, and behaviour (COM-B) model. Methods: A systematic review was conducted by searching five databases (MEDLINE, Scopus, EMBASE, CINAHL, and PsycINFO) and grey literature on 30 August 2020. Data were extracted, thematically analysed, and mapped to the COM-B model. The Joanna Briggs Institute (JBI) critical appraisal tool was utilised to assess the quality of studies. Results: A total of 2929 citations were screened, and 26 articles with a total of 13,429 participants included. Thirty-one factors were identified and mapped to COM-B model: psychological capability (forgetfulness, education), physical capability (level of nicotine dependence, withdrawal symptoms), reflective motivation (perception about NRT and quitting), automatic motivation (alcohol use, stress, depression), physical opportunity (cost), and social opportunity (social support). The most prominent element associated with adherence was reflective motivation followed by physical capability and automatic motivation. Conclusions: Multiple personal, social, and environmental factors affect NRT adherence. Hence, it is recommended to implement a multifaceted behavioural intervention incorporating factors categorised under the COM-B model, which is the hub of the behaviour change wheel (BCW) to improve adherence and quitting.

Suggested Citation

  • Amanual Getnet Mersha & Gillian Sandra Gould & Michelle Bovill & Parivash Eftekhari, 2020. "Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model," IJERPH, MDPI, vol. 17(23), pages 1-21, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:23:p:8895-:d:453611
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    References listed on IDEAS

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    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    2. Ong, M.K. & Glantz, S.A., 2005. "Free nicotine replacement therapy programs vs implementing smoke-free workplaces: A cost-effectiveness comparison," American Journal of Public Health, American Public Health Association, vol. 95(6), pages 969-975.
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