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Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub
BACKGROUND: Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural ev...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780635/ https://www.ncbi.nlm.nih.gov/pubmed/33390191 http://dx.doi.org/10.1186/s40814-020-00739-2 |
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author | Arden, M. A. Hutchings, M. Whelan, P. Drabble, S. J. Beever, D. Bradley, J. M. Hind, D. Ainsworth, J. Maguire, C. Cantrill, H. O’Cathain, A. Wildman, M. |
author_facet | Arden, M. A. Hutchings, M. Whelan, P. Drabble, S. J. Beever, D. Bradley, J. M. Hind, D. Ainsworth, J. Maguire, C. Cantrill, H. O’Cathain, A. Wildman, M. |
author_sort | Arden, M. A. |
collection | PubMed |
description | BACKGROUND: Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural evidence and theory alongside input from people with CF. This intervention is based on a digital platform that collects and displays objective nebuliser adherence data. The purpose of this paper is to identify the specific components of an intervention to increase and maintain adherence to nebuliser treatments in adults with CF with a focus on reducing effort and treatment burden. METHODS: Intervention development was informed by the Behaviour Change Wheel (BCW) and person-based approach (PBA). A multidisciplinary team conducted qualitative research to inform a needs analysis, selected, and refined intervention components and methods of delivery, mapped adherence-related barriers and facilitators, associated intervention functions and behaviour change techniques, and utilised iterative feedback to develop and refine content and processes. RESULTS: Results indicated that people with CF need to understand their treatment, be able to monitor adherence, have treatment goals and feedback and confidence in their ability to adhere, have a treatment plan to develop habits for treatment, and be able to solve problems around treatment adherence. Behaviour change techniques were selected to address each of these needs and were incorporated into the digital intervention developed iteratively, alongside a manual and training for health professionals. Feedback from people with CF and clinicians helped to refine the intervention which could be tailored to individual patient needs. CONCLUSIONS: The intervention development process is underpinned by a strong theoretical framework and evidence base and was developed by a multidisciplinary team with a range of skills and expertise integrated with substantial input from patients and clinicians. This multifaceted development strategy has ensured that the intervention is usable and acceptable to people with CF and clinicians, providing the best chance of success in supporting people with CF with different needs to increase and maintain their adherence. The intervention is being tested in a randomised controlled trial across 19 UK sites. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40814-020-00739-2. |
format | Online Article Text |
id | pubmed-7780635 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77806352021-01-05 Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub Arden, M. A. Hutchings, M. Whelan, P. Drabble, S. J. Beever, D. Bradley, J. M. Hind, D. Ainsworth, J. Maguire, C. Cantrill, H. O’Cathain, A. Wildman, M. Pilot Feasibility Stud Research BACKGROUND: Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural evidence and theory alongside input from people with CF. This intervention is based on a digital platform that collects and displays objective nebuliser adherence data. The purpose of this paper is to identify the specific components of an intervention to increase and maintain adherence to nebuliser treatments in adults with CF with a focus on reducing effort and treatment burden. METHODS: Intervention development was informed by the Behaviour Change Wheel (BCW) and person-based approach (PBA). A multidisciplinary team conducted qualitative research to inform a needs analysis, selected, and refined intervention components and methods of delivery, mapped adherence-related barriers and facilitators, associated intervention functions and behaviour change techniques, and utilised iterative feedback to develop and refine content and processes. RESULTS: Results indicated that people with CF need to understand their treatment, be able to monitor adherence, have treatment goals and feedback and confidence in their ability to adhere, have a treatment plan to develop habits for treatment, and be able to solve problems around treatment adherence. Behaviour change techniques were selected to address each of these needs and were incorporated into the digital intervention developed iteratively, alongside a manual and training for health professionals. Feedback from people with CF and clinicians helped to refine the intervention which could be tailored to individual patient needs. CONCLUSIONS: The intervention development process is underpinned by a strong theoretical framework and evidence base and was developed by a multidisciplinary team with a range of skills and expertise integrated with substantial input from patients and clinicians. This multifaceted development strategy has ensured that the intervention is usable and acceptable to people with CF and clinicians, providing the best chance of success in supporting people with CF with different needs to increase and maintain their adherence. The intervention is being tested in a randomised controlled trial across 19 UK sites. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40814-020-00739-2. BioMed Central 2021-01-04 /pmc/articles/PMC7780635/ /pubmed/33390191 http://dx.doi.org/10.1186/s40814-020-00739-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Arden, M. A. Hutchings, M. Whelan, P. Drabble, S. J. Beever, D. Bradley, J. M. Hind, D. Ainsworth, J. Maguire, C. Cantrill, H. O’Cathain, A. Wildman, M. Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title | Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title_full | Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title_fullStr | Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title_full_unstemmed | Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title_short | Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub |
title_sort | development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: cfhealthhub |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780635/ https://www.ncbi.nlm.nih.gov/pubmed/33390191 http://dx.doi.org/10.1186/s40814-020-00739-2 |
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