WS2: Behaviour Change Techniques to support medication adherence: from face-to-face consultations to digital interventions

Mara Pereira Guerreiro, Lisbon Nursing School, Lisboa, Portugal & Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
Isa Brito Félix, Lisbon Nursing School

Background:

Suboptimal medication adherence, particularly in chronic conditions, is associated with increased morbidity and mortality, increased costs of care and loss of quality of life.

Improving sub-optimal medication adherence requires behaviour change. Behaviour change techniques (BCTs) are defined as an “observable, replicable, and irreducible component of an intervention designed to alter or redirect causal processes that regulate behavior”(1). The BCT taxonomy (1) provides standardised definitions of BCTs, linked to the comprehensive framework Capability Opportunity Motivation-Behaviour (COM-B)(2).

The consistent use of BCTs in consultations provided by pharmacists and other health care professionals is expected to optimise medication adherence, whilst aiding to structure interventions in relation to specific adherence determinants. However, many healthcare professionals are unfamiliar with BCTs and have not been trained in this respect.
Numerous mobile applications to support medication adherence encompass BCTs (3). Familiarisation of health professionals with these BCTs may lead to seamless interventions across face-to-face consultations and self-care supported via commercially available mobile applications.

This workshop will draw on our experience in developing a digital intervention to support self-care in older people with type 2 diabetes (http://vaselfcare.rd.ciencias.ulisboa.pt/index-en.html); this multi-behaviour intervention comprises support to medication adherence through the explicit use of BCTs, guided by the COM-B framework.

Target audience:

The workshop aims to illustrate the application of BCTs to support medication adherence, both in clinical face-to-face consultations and through available mobile applications.

Learning Objectives:

By the end of the workshop participants should be able to:

• Broadly describe BCT Taxonomy v1 (1);
• Explain BCTs commonly used in medication adherence interventions;
• Exemplify the application of selected BCTs to increase or sustain medication adherence in clinical consultations and mobile applications for self-care support;
• List resources to enhance the use of BCTs in medication adherence interventions in clinical practice.

Content and Structure:

Introduction (30 min)
After an ice-breaker activity, we will provide an overview and definition of BCTs commonly used in medication adherence interventions, resorting to the BCT Taxonomy v1, as well as their link to COM-B. Additionally, we will provide examples of operationalisation of these BCTs, both in face-to-face consultations and mobile applications.

Group work (40 min)
Small groups will be convened. Groups will receive cases describing non-adherence to medication in a high priority chronic condition. Each group will be asked to discuss how selected BCTs can be applied in clinical consultations in relation to non-adherence determinants described in the case and to reflect on strategies for implementation in clinical practice. Additionally, examples of mobile applications to support medication adherence will be provided; groups will be asked to identify BCTs in applications features and to reflect on how mobile applications can be integrated in consultations.

Discussion of groups’ outputs (40 min)
Main points emerging from the work of each group will be shared and commented by moderators and participants.

Wrap-up (10 min)
Key messages will be listed and the workshop will be closed.

References
1. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46:81–95.
2. Michie S, Atkins L, West R. The Behavior Change Wheel: A Guide To Designing Interventions. London: Silverback Publishing; 2014.
3. Morrissey EC, Corbett TK, Walsh JC, Molloy GJ. Behavior change techniques in apps for medication adherence: A content analysis. Am J Prev Med.; 2016;50(5):e143–6.

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