Publication date

Implementing adherence interventions in real world settings requires use of multiple implementation strategies: worskhop with interventionists.

Steeg-van Gompel, C. van de, Vervloet, M., Hogervorst, S., Koster, E., Janssen, R., Dijk, L. van. Implementing adherence interventions in real world settings requires use of multiple implementation strategies: worskhop with interventionists. International Journal of Clinical Pharmacy: 2023, 45, p. 527. Abstract 602 of the 13th PCNE Working Conference ‘‘Pharmacies’ new roles in pharmaceutical care: bridging research and practice’,
Read online

Background Implementation of adherence-enhancing interventions in daily clinical practice is not Common. In the Netherlands, four local multidisciplinary groups were funded as a living lab for implementation of a (previously been tested) medication adherence enhancing intervention in their daily practice. All project leads were pharmacists. The implementation process was guided and evaluated by the Medication Adherence Knowledge and Implementation Taskforce (Make-It consortium). One aspect of the evaluation focused on the implementation strategies that are needed to integrate a medication
adherence intervention in daily clinical practive.

The ERIC-study distinguishes 73 implementation strategies that can support implementation of interventions in health care. To explore which and how many of the 73 implementation strategies
from the ERIC-study are used in four local real-world primary care settings (living labs) that implemented pharmacy-led adherence interventions.

The living labs each implemented different interventions: teach-back method at first dispense, annual medication consultation, telephone counseling after hospital discharge and telephone counseling when implementation of the medication regimen fails. During a one-day interactive workshop with two representatives per living lab the members of the Make-It consortium presented the 73 strategies to
the living labs. The representatives were asked to note strategies used in their living lab for different stages over the course of their projects.

All living labs used at least 20 strategies. Overall, 42 strategies were used by at least one living lab, 9 strategies by all. These nine included: Assess for readiness and identify barriers and facilitators, audit and provide feedback, centralize technical assistance, use an implementation advisor, inform local opinion leaders, build a coalition, work with educational institutions, develop educational materials and distribute educational materials. The use of implementation strategies changed over the course of the project:
from creating support and facilitating cooperation in the preparatory stage to supporting health care professionals in implementation and evaluating processes in the execution stage.

The fact that multiple strategies have to be used in different stages of implementing even a relatively simple intervention might be a reason for the lack of implementation so far in the Netherlands and beyond. To implement an adherence intervention in daily practice, a wide range of strategies is needed. The Make-it consortium extracts recommendations from the acquired knowledge to promote wider implementation