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Implementing medication adherence interventions in four Dutch living labs; context matters

Title: Implementing medication adherence interventions in four Dutch living labs; context matters
Authors: Hogervorst, Stijn; Vervloet, Marcia; Janssen, Ruby; Koster, Ellen; Adriaanse, Marcel C; Bekker, Charlotte L; van den Bemt, Bart J F; Bouvy, Marcel; Heerdink, Eibert R; Hugtenburg, Jacqueline G; van Woerkom, Menno; Zwikker, Hanneke; van de Steeg-van Gompel, Caroline; van Dijk, Liset; Afd Pharmacoepi & Clinical Pharmacology; PECP – Centre for Clinical Therapeutics; Pharmacoepidemiology and Clinical Pharmacology
Publication Year: 2023
Subject Terms: Consolidated framework for implementation research (CFIR); Context; Implementation; Innovation; Living labs; Medication adherence; Pharmaceutical care; Real-world setting; Health Policy; SDG 3 - Good Health and Well-being; SDG 13 - Climate Action
Description: BACKGROUND: Despite the abundant availability of effective medication adherence interventions, uptake of these interventions into routine care often lacks. Examples of effective medication adherence interventions include telephone counseling, consult preparation and the teach-back method. Assessing context is an important step in understanding implementation success of interventions, but context is often not reported or only moderately described. This study aims to describe context-specific characteristics in four living labs prior to the implementation of evidence-based interventions aiming to improve medication adherence. METHODS: A qualitative study was conducted within four living labs using individual interviews (n = 12) and focus groups (n = 4) with project leaders and involved healthcare providers. The four living labs are multidisciplinary collaboratives that are early adopters of medication adherence interventions in the Dutch primary care system. Context is defined as the environment or setting in which the proposed change is to be implemented. Interview topics to assess context were formulated based on the 'inner setting' and 'outer setting' domains of the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded and transcribed verbatim. Transcripts were deductively analyzed. RESULTS: A total of 39 community pharmacists, pharmacy technicians, general practitioners and a home care employee participated in the (focus group) interviews. All four living labs proved to be pharmacy-driven and characterized by a high regard for innovation by staff members, a positive implementation climate, high levels of leadership engagement and high compatibility between the living labs and the interventions. Two living labs were larger in size and characterized by more formal communication. Two living labs were characterized by higher levels of cosmopolitanism which resulted in more adaptable interventions. Worries about external policy, most notably lack of reimbursement for sustainment and ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1472-6963
Relation: https://dspace.library.uu.nl/handle/1874/434442
Availability: https://dspace.library.uu.nl/handle/1874/434442
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.7CE08D11
Database: BASE