Effects of Nurse-Led Interventions on Adherence and Clinical Outcomes Among Adults Receiving Noninvasive Ventilation: A Systematic Review of Randomized Controlled Trials

BackgroundNoninvasive ventilation (NIV) is a cornerstone therapy for respiratory diseases, but its effectiveness depends on patient adherence, which remains suboptimal. Although nurses play a key role in NIV management, the effects of nurse-led interventions on adherence and clinical outcomes remain unclear.ObjectiveTo evaluate the effects of nurse-led interventions on NIV adherence and clinical outcomes in adults.MethodsSix databases were searched from inception to January 2026 for English randomized controlled trials (RCTs) involving adults receiving NIV. Two reviewers independently conducted study selection and data extraction. Risk of bias was assessed using the Risk of Bias 2 tool, and the findings were synthesized without meta-analysis.ResultsSixteen RCTs involving 1757 participants were included. Risk of bias ranged from low to high across studies. Interventions included health education, motivational and behavioral strategies, and follow-up support delivered face-to-face, by telephone, or via telehealth. Nurse-led interventions may improve NIV adherence, although the effects varied across intervention types and follow-up periods. Some studies reported improvements in symptom burden, emotional status, and selected health service outcomes, whereas findings on quality of life, self-efficacy, and healthcare utilization were inconsistent.ConclusionsNurse-led interventions may improve NIV adherence, particularly when combining education with motivational and behavioral strategies and structured follow-up.