TIMELY Phase 1 Prototyping Study
Research type
Research Study
Full title
A Text message Intervention to support appropriate adherence to MEdicines from community pharmacY (TIMELY) - Prototyping study of the new intervention
IRAS ID
238875
Contact name
Gemma Donovan
Contact email
Sponsor organisation
University of Sunderland
Duration of Study in the UK
0 years, 6 months, 9 days
Research summary
Research Summary
We know that around half of prescribed medications are not taken by patients as directed. We also know that if people do not take their medication, this can affect their health. Our research team want to find out if a text message service can be developed that people to take their medicines. We would also like to find out if pharmacists (chemists) might be a good place to deliver this text message service to patients.
In this Phase 1 study we want to share parts of our text message service design to patients, pharmacists and GPs in focus groups (discussions with a small number of people about a particular topic). We will hold four focus groups, two for patients only and two for healthcare staff only. Patients will be recruited from primary care, through existing patient participation groups. Any patient who takes at least one medicine for a long term condition can be included in the study.The parts of design that we want to get feedback on include the invitation to a text message intervention for medication adherence, the questionnaire that will be used to personalise the messages people receive, patient information about the intervention, the types of messages patients could receive, and how the intervention might work within the existing health system for patients self-caring at home. This will be done using a range of ‘prototypes’ which include paperwork, videos and diagrams which represent different aspects of the design to date. The feedback will also be summarised and returned to rank which changes are most important. We expect the focus group to last approximately 1½ hours and the ranking around 15 minutes.
The feedback gathered from these focus groups will be used to refine our intervention ready for a Phase 2 study (subject to a separate application).
Summary of Results
This study was the first stage in designing a new intervention to support adherence to medicines using text messages and community pharmacy support.In this phase 1 study, we had 9 patients and 21 healthcare professionals (pharmacists, nurses, general practitioners) included across five focus groups. 17 people also took part in the ranking exercise using the online questionnaire.
Generally, the results of this phase were very positive. There was agreement that a pharmacy setting and a review by a pharmacist was desirable by both patients and professionals. The changes that were suggested have now been incorporated into the design and have started to be tested in Phase 2 studies. A more formal written consent process will be incorporated into setting up patients using text messages for the phase 3 study, and supporting training videos for pharmacy staff will include this. The personalisation questionnaire which was shown to patients as part of the phase 1 study has been changed so that there is a space for pharmacists to record when patients take their medicines. Other changes include confirming long term conditions with the patient and asking if reminders is something patients would find helpful. To make sure that pharmacies offer patients help to complete the questionnaire if needed, this will be included in pharmacist training as part of the phase 3 study in spring 2020. The patient information leaflet has been updated to include information about how long it will take for messages to be replied to, the phone number the text messages will come from, a space for pharmacy details and the replacement of clip-art with photos. The new questionnaire and patient information leaflet will be tested again in a phase 2 study with patients.
Professionals liked the range of different types of messages included in the intervention, especially the support for habit formation. However, they felt uncomfortable with the use of more negatively framed messages. These messages will be tested in a phase 2 study for patient feedback before deciding if they should be included in the final intervention or not. Professionals also wanted more support included for patients to use home monitoring equipment. Home monitoring as part of the intervention will also be tested with patients before making any final changes to how targets are set.
Overall, the focus groups were effective for supporting a co-design process for this new intervention to support medicines adherence. Other researchers may also find these methods helpful. To see if the intervention works to improve medication adherence, it will need to be tested using a clinical trial design. In phase 3 of the TIMELY study the intervention will be delivered by community pharmacies in the NHS to see if it is possible to study this intervention in a clinical trial.
REC name
London - Riverside Research Ethics Committee
REC reference
18/LO/1201
Date of REC Opinion
29 Jun 2018
REC opinion
Favourable Opinion