Implementation and feasibility testing of a primary care medication adherence intervention

Supervisor:

• Professor Debi Bhattacharya d.bhattacharya@leicester.ac.uk

Project description: 

Half of patients do not adhere to prescribed medication directions(1,2). Patients and Health Care Professionals (HCPs) struggle to identify a patient’s main barriers to adherence and therefore fail to select tailored interventions. We have developed and validated the 10-item ‘Identification of Medication Adherence Barriers Questionnaire’ (IMAB-Q)(3). The IMAB-Q diagnoses a patient’s main barriers to adherence. Each IMAB-Q barrier is linked to theory and evidence-based adherence interventions from which HCPs and patients can select. The IMAB-Q to identify barriers to adherence combined with interventions to address them forms the IMAB-Q intervention (IMAB-Qi).

Medication reviews in general practices require HCPs to identify and address non-adherence. Implementing IMAB-Qi into medication reviews fulfils this requirement. Our previous research has determined that general practice teams require an implementation package to deliver the IMAB-Qi within existing MRs.

In the initial phase of the PhD, you will develop an implementation package to support general practice teams to deliver the IMAB-Qi within medication reviews. You will use novel user testing methodology and implementation science to diagnose the barriers and enablers to IMAB-Qi delivery and co-design methodology to develop the implementation package.

In the latter phase of the PhD, you will design and undertake a study to test the feasibility of a future definitive trial to evaluate the effectiveness and cost-effectiveness of the IMAB-Qi.

The successful candidate will be embedded within the IMAB-Qi research team which is funded by an NIHR Programme Grant for Applied Research. The team is led by Professor Debi Bhattacharya (primary PhD supervisor) and Dr Sion Scott and includes healthcare professionals, researchers and patient and public involvement members. This PhD therefore offers the highly desirable combination of formal support from a supervisory team whilst drawing on the expertise of the wider IMAB-Qi research team.

As an NIHR-funded PhD studentship, the successful candidate will become a member of the NIHR Academy and benefit from the training, career development and research capacity development support offered. Assuming that the PhD commences in Autumn 2024 and is completed within 3 years, the candidate may apply for a postdoctoral research associate role on the IMAB-Qi research programme to work on the definitive trial.

The ideal candidate will have excellent knowledge of the NHS primary care landscape. Some knowledge and/or experience of medication reviews in primary care is beneficial but not essential.

References: 
1. Nieuwlaat R, Wilczynski N, Navarro T, Hobson N, Jeffery R, Keepanasseril A, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2014;(11). 
2. Sabaté E, World Health Organization, editors. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003. 198 p. 
3. Bhattacharya D, Brown TJ, Clark AB, Dima AL, Easthall C, Taylor N, et al. Validation of the Identification of Medication Adherence Barriers Questionnaire (IMAB-Q); a Behavioural Science-Underpinned Tool for Identifying Non-Adherence and Diagnosing an Individual’s Barriers to Adherence. Patient Prefer Adherence. 2023 Nov;Volume 17:2991–3000.