M A Arden1, M Hutchings2, P Whelan3, S J Drabble4, D Beever5, J M Bradley6, D Hind5, J Ainsworth3, C Maguire5, H Cantrill5, A O'Cathain4, M Wildman2. 1. Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, 2.03a Heart of the Campus, Collegiate Crescent Campus, Sheffield, S10 2BQ, UK. m.arden@shu.ac.uk. 2. Sheffield Adult Cystic Fibrosis Unit Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK. 3. Health eResearch Centre-Farr Institute, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9GB, UK. 4. School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. 5. Clinical Trials Research Unit, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. 6. Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, 97 Lisburn Road, Belfast, BT9 7BL, UK.
Abstract
BACKGROUND:Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural evidence and theory alongside input from people with CF. This intervention is based on a digital platform that collects and displays objective nebuliser adherence data. The purpose of this paper is to identify the specific components of an intervention to increase and maintain adherence to nebuliser treatments in adults with CF with a focus on reducing effort and treatment burden. METHODS: Intervention development was informed by the Behaviour Change Wheel (BCW) and person-based approach (PBA). A multidisciplinary team conducted qualitative research to inform a needs analysis, selected, and refined intervention components and methods of delivery, mapped adherence-related barriers and facilitators, associated intervention functions and behaviour change techniques, and utilised iterative feedback to develop and refine content and processes. RESULTS: Results indicated that people with CF need to understand their treatment, be able to monitor adherence, have treatment goals and feedback and confidence in their ability to adhere, have a treatment plan to develop habits for treatment, and be able to solve problems around treatment adherence. Behaviour change techniques were selected to address each of these needs and were incorporated into the digital intervention developed iteratively, alongside a manual and training for health professionals. Feedback from people with CF and clinicians helped to refine the intervention which could be tailored to individual patient needs. CONCLUSIONS: The intervention development process is underpinned by a strong theoretical framework and evidence base and was developed by a multidisciplinary team with a range of skills and expertise integrated with substantial input from patients and clinicians. This multifaceted development strategy has ensured that the intervention is usable and acceptable to people with CF and clinicians, providing the best chance of success in supporting people with CF with different needs to increase and maintain their adherence. The intervention is being tested in a randomised controlled trial across 19 UK sites.
RCT Entities:
BACKGROUND:Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural evidence and theory alongside input from people with CF. This intervention is based on a digital platform that collects and displays objective nebuliser adherence data. The purpose of this paper is to identify the specific components of an intervention to increase and maintain adherence to nebuliser treatments in adults with CF with a focus on reducing effort and treatment burden. METHODS: Intervention development was informed by the Behaviour Change Wheel (BCW) and person-based approach (PBA). A multidisciplinary team conducted qualitative research to inform a needs analysis, selected, and refined intervention components and methods of delivery, mapped adherence-related barriers and facilitators, associated intervention functions and behaviour change techniques, and utilised iterative feedback to develop and refine content and processes. RESULTS: Results indicated that people with CF need to understand their treatment, be able to monitor adherence, have treatment goals and feedback and confidence in their ability to adhere, have a treatment plan to develop habits for treatment, and be able to solve problems around treatment adherence. Behaviour change techniques were selected to address each of these needs and were incorporated into the digital intervention developed iteratively, alongside a manual and training for health professionals. Feedback from people with CF and clinicians helped to refine the intervention which could be tailored to individual patient needs. CONCLUSIONS: The intervention development process is underpinned by a strong theoretical framework and evidence base and was developed by a multidisciplinary team with a range of skills and expertise integrated with substantial input from patients and clinicians. This multifaceted development strategy has ensured that the intervention is usable and acceptable to people with CF and clinicians, providing the best chance of success in supporting people with CF with different needs to increase and maintain their adherence. The intervention is being tested in a randomised controlled trial across 19 UK sites.
Authors: Alexandra L Quittner; Jie Zhang; Maryna Marynchenko; Pooja A Chopra; James Signorovitch; Yana Yushkina; Kristin A Riekert Journal: Chest Date: 2014-07 Impact factor: 9.410
Authors: Simon D French; Sally E Green; Denise A O'Connor; Joanne E McKenzie; Jill J Francis; Susan Michie; Rachelle Buchbinder; Peter Schattner; Neil Spike; Jeremy M Grimshaw Journal: Implement Sci Date: 2012-04-24 Impact factor: 7.327
Authors: Sarah J Drabble; Alicia O'Cathain; Madelynne A Arden; Marlene Hutchings; Daniel Beever; Martin Wildman Journal: Qual Health Res Date: 2019-07-13
Authors: Daniel Hind; Sarah J Drabble; Madelynne A Arden; Laura Mandefield; Simon Waterhouse; Chin Maguire; Hannah Cantrill; Louisa Robinson; Daniel Beever; Alexander J Scott; Sam Keating; Marlene Hutchings; Judy Bradley; Julia Nightingale; Mark I Allenby; Jane Dewar; Pauline Whelan; John Ainsworth; Stephen J Walters; Alicia O'Cathain; Martin J Wildman Journal: BMC Pulm Med Date: 2019-04-11 Impact factor: 3.317
Authors: Martin J Wildman; Alicia O'Cathain; Chin Maguire; Madelynne A Arden; Marlene Hutchings; Judy Bradley; Stephen J Walters; Pauline Whelan; John Ainsworth; Iain Buchan; Laura Mandefield; Laura Sutton; Paul Tappenden; Rachel A Elliott; Zhe Hui Hoo; Sarah J Drabble; Daniel Beever Journal: Thorax Date: 2021-09-23 Impact factor: 9.102