Development and piloting of a highly tailored text and voice messaging intervention to support adherence to antihypertensive medications within the primary care setting (Preprint)

Kassavou, Aikaterini; Houghton, Vikki; Edwards, Simon; Brimicombe, James; Sutton, Stephen

doi:10.2196/preprints.9724

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…The theoretical framework that distinguishes between intentional non-adherence (INA) and non-intentional non-adherence (NINA) guided the development of this intervention 21. To address INA and NINA, we identified the empirical evidence of the proximal and modifiable determinants of adherence to medication22 and mapped them into INA and NINA framework. Following that, we used the taxonomy of the behaviour change techniques (BCTs)23 to identify the techniques that impact on INA and NINA determinants (see online supplementary appendix 3).…”

Section: Methodsmentioning

confidence: 99%

Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations

et al. 2019

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ObjectivesThis paper describes the systematic development and piloting of a highly tailored text and voice message intervention to increase adherence to medication in primary care.MethodsFollowing the Medical Research Council guidance, this paper describes (a) the systematic development of the theoretical framework, based on review of theories and meta-analyses of effectiveness; (b) the systematic development of the delivery mode, intervention content and implementation procedures, based on consultations, face-to-face interviews, think-aloud protocols, focus groups, systematic reviews, patient and public involvement/engagement input, intervention pre-test; and (c) the piloting of the intervention, based on a 1-month intervention; and follow-up assessment including interviews and questionnaires. The mixed-methods analysis combined findings from the parallel studies complementarily.Resultsintervention development suggested the target behaviour of the intervention should be the tablets taken at a regular time of the day. It recommended that patients could be more receptive to intervention content when they initiate medication taking or they change prescription plan; and more emphasis is needed to patients’ consent process. Intervention piloting suggested high intervention engagement with, and fidelity of, the intervention content; which included a combination of behaviour change techniques, and was highly tailored to patients’ beliefs and prescription plan. Patients reported that the intervention content increased awareness about the necessity to take and maintain adherent to medication, reinforced social support and habit formation, and reminded them to take medication as prescribed.ConclusionTailored automated text and voice message interventions are feasible ways to improve medication adherence as an adjunct to primary care.Trial registration number ISRCTN10668149.

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Section: Methodsmentioning

confidence: 99%

Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations

et al. 2019

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“…However, no such intervention has been developed and tested in the UK primary-care setting. To address this gap, we developed the Medication Adherence for Patient’s Support (MAPS) intervention (Kassavou et al, 2018). MAPS is a text and voice message intervention that provides highly tailored support to improve medication adherence, as an adjunct to primary-care consultations.…”

Section: Introductionmentioning

confidence: 99%

“…It includes behavior change techniques (BCTs), mapped onto each of the INA/NINA theoretical determinants (e.g. beliefs about medication and self-efficacy), is personalized, and targets taking and collecting medications (Kassavou and Sutton, 2016).…”

Section: Introductionmentioning

confidence: 99%

Acceptability of the Medication Adherence for Patients Support intervention to improve adherence to patients prescribed medications for hypertension or comorbidities, as an adjunct to primary care: A qualitative study

et al. 2018

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Tailored interventions delivered via text and voice messages can improve adherence to multiple medications. However, no such intervention has been developed in the UK primary-care setting. We conducted focus groups with 12 patients with hypertension, type 2 diabetes, or both conditions, presumed to be non-adherent and recruited from deprived neighborhoods, to assess the acceptability and inform the development of an intervention to provide ongoing support for adherence, as an adjunct to primary-care consultations. Patients recommended ways to improve the tailored content and delivery of the intervention; like highly interactive messages to report both medication taking and determinants of medication adherence.

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Reasons for non-adherence to cardiometabolic medications, and acceptability of an interactive voice response intervention in patients with hypertension and type 2 diabetes in primary care: a qualitative study

Kassavou

Sutton

2017

BMJ Open

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ObjectivesThis study explored the reasons for patients’ non-adherence to cardiometabolic medications, and tested the acceptability of the interactive voice response (IVR) as a way to address these reasons, and support patients, between primary care consultations.Design, method, participants and settingThe study included face-to-face interviews with 19 patients with hypertension and/or type 2 diabetes mellitus, selected from primary care databases, and presumed to be non-adherent. Thirteen of these patients pretested elements of the IVR intervention few months later, using a think-aloud protocol. Five practice nurses were interviewed. Data were analysed using multiperspective, and longitudinalthematic analysis.ResultsNegative beliefs about taking medications, the complexity of prescribed medication regimens, and the limited ability to cope with the underlying affective state, within challenging contexts, were mentioned as important reasons for non-adherence. Nurses reported time constraints to address each patient’s different reasons for non-adherence, and limited efficacy to support patients, between primary care consultations. Patients gave positive experiential feedback about the IVR messages as a way to support them take their medicines, and provided recommendations for intervention content and delivery mode. Specifically, they liked the voice delivering the messages and the voice recognition software. For intervention content, they preferred messages that were tailored, and included messages with ‘information about health consequences’, ‘action plans’, or simple reminders for performing the behaviour.ConclusionsPatients with hypertension and/or type 2 diabetes, and practice nurses, suggested messages tailored to each patient’s reasons for non-adherence. Participants recommended IVR as an acceptable platform to support adherence to cardiometabolic medications between primary care consultations. Future studies could usefully test the acceptability, and feasibility, of tailored IVR interventions to support medication adherence, as an adjunct to primary care.

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Development and piloting of a highly tailored text and voice messaging intervention to support adherence to antihypertensive medications within the primary care setting (Preprint)

Abstract: Background: tailored automated text and voice message interventions are effective ways to

Cited by 3 publications

References 14 publications

Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations

Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations

Acceptability of the Medication Adherence for Patients Support intervention to improve adherence to patients prescribed medications for hypertension or comorbidities, as an adjunct to primary care: A qualitative study

Reasons for non-adherence to cardiometabolic medications, and acceptability of an interactive voice response intervention in patients with hypertension and type 2 diabetes in primary care: a qualitative study

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