Marcia Vervloet
Senior onderzoeker Patiëntperspectief, Participatie en Zorg
Publicatie
Datum
30-03-2026
A framework tailored to assess the implementability of medication adherence interventions: CFIR-adherence.
Oude Lansink, M., Bemt, B. van den, Steeg, C. van de, Vervloet, M., Dijk, L. van, Bekker, C. A framework tailored to assess the implementability of medication adherence interventions: CFIR-adherence. Implementation Science: 2026. 21(Suppl. 1), RtKW 4.3. Meeting Abstract –Proceedings of the 2025 European Implementation Event. Implementation impact in the age of complexity: walking the tightrope between scientific rigour and real‑world pragmatism.
ABSTRACT:
Background
Although effective medication adherence interventions exist, they are hardly implemented in clinical practice. This study, therefore, aims to facilitate the implementation of adherence-improving interventions by creating a tailored framework that assesses the implementability medication adherence interventions in a specific context in advance.
Methods
A Delphi study was conducted with Dutch adherence experts in the first stage. In the second stage, a prospective evaluation was performed in four living labs, consisting of Dutch community pharmacies and related general practices that were implementing medication adherence interventions.
Experts in the Delphi study rated determinants of the Consolidated Framework for Implementation (CFIR) on their importance for implementing medication adherence interventions, with consensus defined as more than 70% (dis)agreement. In the second stage, implementation determinants were identified after prospective evaluation using project meeting documentation and interview transcripts. These determinants were analysed using the CFIR. Determinants that influenced the implementation in 75% or more of the living labs were included in the tailored framework. Results of the two stages were compared to assess agreement between expert opinions and observations in real-world practice.
Results
Eighteen adherence experts participated in the Delphi study. Of the 40 CFIR constructs, 28 were considered important for implementing medication adherence interventions. After prospective evaluation, 16 determinants were observed as important in the living labs and included in the tailored implementation framework for medication adherence interventions. These determinants belonged to the inner setting, characteristics and roles of involved individuals and implementation process domains. Expert expectations matched living lab observations for 18 (45%) determinants regarding their (un)importance.
Discussion and conclusion
This study developed a tailored framework to assess the implementability of medication adherence interventions in specific settings in advance. Our study suggests that the organisation's context, characteristics and roles of involved individuals and the actions undertaken to stimulate the implementation process are important for implementing medication adherence interventions. A discrepancy was found between expert opinions and observed determinants regarding their importance for implementing medication adherence interventions.
