Stijn Hogervorst1,2, Marcel Adriaanse3,4, Hella Brandt3,4, Marcia Vervloet5, Liset van Dijk5,6, Jacqueline Hugtenburg4,7. 1. Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands. s.hogervorst@vu.nl. 2. Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. s.hogervorst@vu.nl. 3. Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands. 4. Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. 5. Department of Pharmaceutical Care, Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. 6. Department of PharmacoTherapy, Epidemiology & Economics (PTEE), Faculty of Mathematics and Natural Sciences, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands. 7. Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, Location VUMC, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Abstract
PURPOSE: The purpose of this feasibility study was to improve and implement an intervention aimed at enhancing medication adherence in sub-optimally controlled and non-adherent type 2 diabetes (T2DM) patients in primary care. METHODS: Four phases were completed: (1) context analysis, (2) collaboration protocol development, (3) digitalization, and (4) process evaluation. Two community pharmacies and seven general practices participated. In phase 1, two focus groups were conducted, of which one with healthcare providers (HCP, N = 5) and one with patients (N = 11). In phase 4, four semi-structured interviews and one focus group (N = 6) were conducted with healthcare providers. The goal of these focus groups and interviews was to obtain insights into current care to support medication adherence (phase 1), opportunities for collaboration (phase 2) and process evaluation (phase 4). Data were analyzed in Atlas.ti using thematic analyses. RESULTS: Both T2DM patients and HCPs considered medication adherence vital. Suboptimal collaboration between HCPs and unreliable ways to monitor medication non-adherence appeared important barriers for adequate care to support medication adherence (phase 1). The nurse practitioner (NP) was chosen as the interventionist with supportive roles for other HCPs (phase 2). All components of the intervention were digitalized (phase 3). The implementation of the digitalized intervention was reported to be suboptimal (phase 4). Main reasons were that pharmacy refill data were unreliable, NPs experienced difficulties addressing medication non-adherence adequately and collaboration between HCPs was suboptimal. CONCLUSIONS: The medication adherence enhancing intervention was successfully digitalized, but implementation of the digitalized intervention appeared not feasible as of yet.
PURPOSE: The purpose of this feasibility study was to improve and implement an intervention aimed at enhancing medication adherence in sub-optimally controlled and non-adherent type 2 diabetes (T2DM) patients in primary care. METHODS: Four phases were completed: (1) context analysis, (2) collaboration protocol development, (3) digitalization, and (4) process evaluation. Two community pharmacies and seven general practices participated. In phase 1, two focus groups were conducted, of which one with healthcare providers (HCP, N = 5) and one with patients (N = 11). In phase 4, four semi-structured interviews and one focus group (N = 6) were conducted with healthcare providers. The goal of these focus groups and interviews was to obtain insights into current care to support medication adherence (phase 1), opportunities for collaboration (phase 2) and process evaluation (phase 4). Data were analyzed in Atlas.ti using thematic analyses. RESULTS: Both T2DM patients and HCPs considered medication adherence vital. Suboptimal collaboration between HCPs and unreliable ways to monitor medication non-adherence appeared important barriers for adequate care to support medication adherence (phase 1). The nurse practitioner (NP) was chosen as the interventionist with supportive roles for other HCPs (phase 2). All components of the intervention were digitalized (phase 3). The implementation of the digitalized intervention was reported to be suboptimal (phase 4). Main reasons were that pharmacy refill data were unreliable, NPs experienced difficulties addressing medication non-adherence adequately and collaboration between HCPs was suboptimal. CONCLUSIONS: The medication adherence enhancing intervention was successfully digitalized, but implementation of the digitalized intervention appeared not feasible as of yet.
Authors: Ana Palacio; Desiree Garay; Benjamin Langer; Janielle Taylor; Barbara A Wood; Leonardo Tamariz Journal: J Gen Intern Med Date: 2016-05-09 Impact factor: 5.128
Authors: Danielle M van der Laan; Petra J M Elders; Christel C L M Boons; Giel Nijpels; Liset van Dijk; Jacqueline G Hugtenburg Journal: Front Pharmacol Date: 2018-09-26 Impact factor: 5.810