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Many implementation strategies needed to implement adherence interventions in local real-world settings.

Steeg-van Gompel, C. van de, Vervloet, M., Hogervorst, S., Koster, E.S., Janssen, R., Dijk, L. van. Many implementation strategies needed to implement adherence interventions in local real-world settings. International Journal of Clinical Pharmacy: 2023, 45, p. 269. Abstract of the 26th Annual Meeting of ESPACOMP, the International Society for Medication Adherence, Berlin, Germany, 17–19 November 2022
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Implementation of adherence-enhancing interventions in real world settings is not common in the Netherlands. The ERICstudy distinguished 73 implementation strategies that can support implementation of interventions in health care.

To explore which and how many of the 73 implementation strategies are used in four local real-world primary care settings (living labs) that implement adherence interventions.

The living labs each implemented different interventions for the initiation or implementation stage of adherence: teach-back, annual medication consultation or telephone counseling (29). In a
one-day interactive workshop with two representatives per living lab the supporting research consortium (Make-It) presented the 73 strategies. Representatives were asked to note and explain strategies
used in their living lab.

Overall, 49 strategies were used by at least one living lab, 11 strategies by all. The living labs used 21, 23, 24 and 40 strategies respectively. 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 relatively simple interventions might be a reason for the lack of implementation.

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 to begin with a group of 4 other living labs.