scholarly journals Development of a complex community pharmacy intervention package using theory-based behaviour change techniques to improve older adults’ medication adherence

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
D. E. Patton ◽  
C. Ryan ◽  
C. M. Hughes
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Community Pharmacy ◽  
Behaviour Change ◽  
Behaviour Change Techniques ◽  
Intervention Package ◽  
Pharmacy Intervention

scholarly journals Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035793 ◽  
Author(s):  
Marta Santillo ◽  
Marta Wanat ◽  
Mina Davoudianfar ◽  
Emily Bongard ◽  
Sinisa Savic ◽  
...  
Keyword(s):  
General Practice ◽  
Behaviour Change ◽  
Controlled Trial ◽  
Intervention Development ◽  
Penicillin Allergy ◽  
Feasibility Trial ◽  
Rapid Review ◽  
Behavioural Intervention ◽  
Behaviour Change Techniques ◽  
Intervention Package

ObjectivesTo develop a behavioural intervention package to support clinicians and patients to amend incorrect penicillin allergy records in general practice. The intervention aimed to: (1) support clinicians to refer patients for penicillin allergy testing (PAT), (2) support patients to attend for PAT and (3) support clinicians and patients to prescribe or consume penicillin, when indicated, following a negative PAT result.MethodsTheory-based, evidence-based and person-based approaches were used in the intervention development. We used evidence from a rapid review, two qualitative studies, and expert consultations with the clinical research team to identify the intervention ‘guiding principles’ and develop an intervention plan. Barriers and facilitators to the target behaviours were mapped to behaviour change theory in order to describe the proposed mechanisms of change. In the final stage, think-aloud interviews were conducted to optimise intervention materials.ResultsThe collated evidence showed that the key barriers to referral of patients by clinicians were limited experience of referral and limited knowledge of referral criteria and PAT. Barriers for patients attending PAT were lack of knowledge of the benefits of testing and lack of motivation to get tested. The key barriers to the prescription and consumption of first-line penicillin following a negative test result were patient and clinician beliefs about the accuracy of PAT and whether taking penicillin was safe. Intervention materials were designed and developed to address these barriers.ConclusionsWe present a novel behavioural intervention package designed to address the multiple barriers to uptake of PAT in general practice by clinicians and patients. The intervention development details how behaviour change techniques have been incorporated to hypothesise how the intervention is likely to work to help amend incorrect penicillin allergy records. The intervention will go on to be tested in a feasibility trial and randomised controlled trial in England.

scholarly journals Implementing the use of objective medication adherence data in routine clinical practice via the digital CFHealthHub platform: situation analysis and strategy development using the theoretical domains framework

2021 ◽  
Author(s):  
Carla Girling ◽  
Anna Packham ◽  
Louisa Robinson ◽  
Madelynne A Arden ◽  
Daniel Hind ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Medication Adherence ◽  
Behaviour Change ◽  
Implementation Strategy ◽  
Clinical Care ◽  
Theoretical Domains Framework ◽  
Behaviour Change Techniques ◽  
Implementation Phase ◽  
Adherence Data ◽  
Healthcare Innovation

Abstract Background Preventative inhaled treatments preserve lung function and reduce exacerbations in Cystic Fibrosis (CF). Self-reported adherence to these treatments is over-estimated. An online platform (CFHealthHub) has been developed with patients and clinicians to display real-time objective adherence data from dose-counting nebulisers, so that clinical teams can offer informed treatment support. Methods In this paper, we identify pre-implementation barriers to healthcare practitioners performing two key behaviours: accessing objective adherence data through the website CFHealthHub and discussing medication adherence with patients. We aimed to understand barriers during the pre-implementation phase, so that appropriate strategy could be developed for the scale up of implementing objective adherence data in 19 CF centres. Thirteen semi-structured interviews were conducted with healthcare practitioners working in three UK CF centres. Qualitative data were coded using the Theoretical Domains Framework (TDF), which describes 14 validated domains to implementation behaviour change. Results Analysis indicated that an implementation strategy should address all 14 domains of the TDF to successfully support implementation. Participants did not report routines or habits for using objective adherence data in clinical care. Examples of salient barriers included skills, beliefs in consequences, and social influence and professional roles. The results also affirmed a requirement to address organisational barriers. Relevant behaviour change techniques were selected to develop implementation strategy modules using the behaviour change wheel approach to intervention development. ConclusionsThis paper demonstrates the value of applying the TDF at pre-implementation, to understand context and to support the development of a situationally relevant implementation strategy. Contribution to the literature· Research indicates that the implementation of healthcare innovations may be more likely to succeed when context and theory are taken into consideration. · In this study, healthcare professionals identified barriers to two behaviours that were key to the implementation of a national Cystic Fibrosis (CF) healthcare innovation. By coding barriers to the Theoretical Domains Framework (TDF), a contextually relevant implementation strategy was developed, with a focus on clinician behaviour change. · The study highlights the challenges CF teams face when implementing new remote monitoring of medication adherence, and provides an important opportunity to apply the TDF in the pre-implementation phase of a healthcare innovation.

scholarly journals Determinants of Behaviour Change in a Multi-Component Telemonitoring Intervention for Community-Dwelling Older Adults

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1062 ◽  
Author(s):  
Marije van Doorn-van Atten ◽  
Lisette de Groot ◽  
Jeanne de Vries ◽  
Annemien Haveman-Nies
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Behaviour Change ◽  
Diet Quality ◽  
Community Dwelling ◽  
Control Group ◽  
Behaviour Change Techniques ◽  
Self Monitoring ◽  
Behavioural Determinants

Optimal diet quality and physical activity levels are essential for healthy ageing. This study evaluated the effects of a multi-component telemonitoring intervention on behavioural determinants of diet quality and physical activity in older adults, and assessed the mediating role of these determinants and two behaviour change techniques in the intervention’s effects. A non-randomised controlled design was used including 214 participants (average age 80 years) who were allocated to the intervention or control group based on municipality. The six-month intervention consisted of self-measurements of nutritional outcomes and physical activity, education, and follow-up by a nurse. The control group received regular care. Measurements took place at baseline, after 4.5 months and at the end of the study. The intervention increased self-monitoring and improved knowledge and perceived behavioural control for physical activity. Increased self-monitoring mediated the intervention’s effect on diet quality, fruit intake, and saturated fatty acids intake. Improved knowledge mediated the effect on protein intake. Concluding, this intervention led to improvements in behavioural determinants of diet quality and physical activity. The role of the hypothesised mediators was limited. Insight into these mechanisms of impact provides directions for future development of nutritional eHealth interventions for older adults, in which self-monitoring may be a promising behaviour change technique. More research is necessary into how behaviour change is established in telemonitoring interventions for older adults.

scholarly journals Group-Based Nutrition Interventions to Promote Health and Mobility in Community-Dwelling Older Adults: A Systematic Review

2021 ◽  
Author(s):  
Kylie Teggart ◽  
Rebecca Ganann ◽  
Davneet Sihota ◽  
Caroline Moore ◽  
Heather Keller ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutrition Education ◽  
Behaviour Change ◽  
Food Access ◽  
Critical Appraisal ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Behaviour Change Techniques ◽  
Nutrition Interventions ◽  
Community Dwelling Older Adults

Abstract Objective: To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status, and improve physical mobility among community-dwelling older adults.Design: Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO, and Sociological Abstracts were searched on July 15, 2020, for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute’s critical appraisal tools), and data extraction were performed in duplicate by two independent reviewers.Setting: Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded.Participants: Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded.Results: Thirty-one experimental and quasi-experimental studies with generally unclear-high risk of bias were included. A broad range of interventions were identified, including nutrition education with behaviour change techniques (e.g., goal setting, interactive cooking demonstrations) (n=21), didactic nutrition education (n=4), interactive nutrition education (n=2), food access (n=2), and nutrition education with behaviour change techniques and food access (n=2). Group-based nutrition education with behaviour change techniques demonstrated the most promise in improving food and fluid intake, nutritional status, and healthy eating knowledge compared to baseline or control. The impact on mobility outcomes was unclear. Conclusions: Our findings should be interpreted with caution related to generally low certainty, unclear-high risk of bias, and high heterogeneity across interventions and outcomes in this body of literature. Quality research in group-based nutrition education for older adults is needed.

scholarly journals Behaviour change techniques to facilitate physical activity in older adults: what and how

2017 ◽  
Vol 38 (12) ◽  
pp. 2590-2616 ◽  
Author(s):  
URSKA ARNAUTOVSKA ◽  
FRANCES O'CALLAGHAN ◽  
KYRA HAMILTON
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Behaviour Change ◽  
Autonomy Support ◽  
Low Cost ◽  
Informed Choice ◽  
Behaviour Change Techniques ◽  
Programme Implementation ◽  
Key Aspects ◽  
And Coping

ABSTRACTPhysical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.

Sign in / Sign up

Export Citation Format

Share Document