Abstract
Background:
Heart Failure (HF) is a major cause of poor health, hospitalisation, and death, particularly amongst older people. Routinely prescribed HF medication can improve these outcomes, but many patients do not take their medications. Aims: To develop a tailored multi-component intervention to enhance medication adherence in older HF patients in preparation for a future pilot RCT. Objectives: To determine what intervention components and strategies are necessary and acceptable to create a support package to help and encourage HF patients to take their medication regularly. To develop an intervention manual to support the delivery of the proposed intervention.
Research methodology:
The study is an intervention development study using qualitative methods and an intervention development tool. To ensure that the experiences, beliefs, and preferences of HF patients are included the intervention is being co-developed with stakeholders including patients, informal carers, cardiologists, geriatricians, health psychologists, HF nurses and pharmacists using an iterative process where decisions about content, format, style and delivery are made together. Findings from previous work are being mapped to the Behaviour Change Wheel (BCW) and the Theoretical Domains Framework(TDF). Key factors known to improve adherence will be combined with motivational strategies and factors personal to each individual to develop a novel intervention. An expert panel including two HF patients will meet to co-design discuss, review, and agree the mapping decisions. Once the behaviours to be targeted for change are identified the TDF will be used to specify these behaviours in terms of who needs to do what differently, when, where how and with whom? During the process HF patients will also be recruited to participate in several focus groups to evaluate the outcomes of the mapping exercise and identify any concerns or potential barriers to delivery as the intervention is refined. Finally the intervention will be manualised ready for piloting.