Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process evaluation
| Autor: | Daniel Hind, Jane Dewar, J.A. Nightingale, Madelynne A Arden, Daniel Beever, Samuel Keating, Judy Bradley, Sarah J Drabble, Chin Maguire, Louisa Robinson, Hannah Cantrill, Stephen J Walters, Alicia O’Cathain, John Ainsworth, Marlene Hutchings, Laura Mandefield, Mark I. Allenby, Simon Waterhouse, Pauline Whelan, Martin J Wildman, Alexander J Scott |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Cystic Fibrosis quality in healthcare media_common.quotation_subject statistics & research methods Psychological intervention Fidelity Health informatics Cystic fibrosis Medication Adherence cystic fibrosis social medicine RC705 RA0421 Social medicine Intervention (counseling) Surveys and Questionnaires medicine Humans health informatics Respiratory Medicine media_common Medicine(all) clinical trials business.industry Nebulizers and Vaporizers R735 General Medicine medicine.disease Clinical trial Physical therapy Feasibility Studies Medicine Process evaluation business RA |
| Zdroj: | BMJ Open, Vol 10, Iss 10 (2020) BMJ Open Hind, D, Drabble, S J, Arden, M A, Mandefield, L, Waterhouse, S, Maguire, C, Cantrill, H, Robinson, L, Beever, D, Scott, A, Keating, S, Hutchings, M, Bradley, J, Nightingale, J, Allenby, M I, Dewar, J, Whelan, P, Ainsworth, J, Walters, S J, Wildman, M J & O'Cathain, A 2020, ' Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process evaluation ', BMJ Open, vol. 10, e039089 . https://doi.org/10.1136/bmjopen-2020-039089 |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesTo undertake a process evaluation of an adherence support intervention for people with cystic fibrosis (PWCF), to assess its feasibility and acceptability.SettingTwo UK cystic fibrosis (CF) units.ParticipantsFourteen adult PWCF; three professionals delivering adherence support (‘interventionists’); five multi-disciplinary CF team members.InterventionsNebuliser with data recording and transfer capability, linked to a software platform, and strategies to support adherence to nebulised treatments facilitated by interventionists over 5 months (± 1 month).Primary and secondary measuresFeasibility and acceptability of the intervention, assessed through semistructured interviews, questionnaires, fidelity assessments and click analytics.ResultsInterventionists were complimentary about the intervention and training. Key barriers to intervention feasibility and acceptability were identified. Interventionists had difficulty finding clinic space and time in normal working hours to conduct review visits. As a result, fewer than expected intervention visits were conducted and interviews indicated this may explain low adherence in some intervention arm participants. Adherence levels appeared to be >100% for some patients, due to inaccurate prescription data, particularly in patients with complex treatment regimens. Flatlines in adherence data at the start of the study were linked to device connectivity problems. Content and delivery quality fidelity were 100% and 60%–92%, respectively, indicating that interventionists needed to focus more on intervention ‘active ingredients’ during sessions.ConclusionsThe process evaluation led to 14 key changes to intervention procedures to overcome barriers to intervention success. With the identified changes, it is feasible and acceptable to support medication adherence with this intervention.Trial registration numberISRCTN13076797; Results. |
| Databáze: | OpenAIRE |
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