Supporting medication adherence using Interactive-Voice-Response (IVR): development and delivery of a theory- and evidence-based intervention

Abstract

Background: non-adherence to anti-hypertensive medications is a significant challenge to public health, and primary care practitioners have limited time to address each patient’s reasons for non-adherence. Our recent meta-analysis of RCTs suggested that IVR interventions can promote medication adherence. However, no such intervention is available in the UK. The aims of this presentation are to describe the process of developing an IVR intervention to promote medication adherence in patients with hypertension, as an adjunct to primary care, and to present evidence on its acceptability. Methods: we used a guide to development and evaluation of digital behaviour change interventions (West&Michie), and followed five phases: (a) exploratory face-to-face interviews with twenty non-adherent patients and five health care providers to identify patients’ reasons for non-adherence, and to assess the acceptability of an IVR intervention, (b) mapping of effective behaviour change techniques to proximal determinants of medication adherence, (c) development of tailored voice messages, (d) development of the IVR platform, and (e) feedback using think-aloud protocol with targeted population. Analysis was informed by the constant comparison approach, with findings from each phase informing subsequent phases. Findings and discussion: We developed the first IVR intervention to promote medication adherence in people with hypertension in the UK, based on theory and evidence. The intervention aims to encourage patients to take their medications as prescribed using personalised and tailored voice messages targeting perceived self-efficacy, affective attitudes, health outcome expectations and habit formation. A 4-week intervention study will test further its feasibility and potential effects on medication adherence.