Fidelity and engagement to a highly tailored Interactive-Voice-Response intervention to support medication adherence, as an adjunct to primary care. A pilot study. Katerina Kassavou, Vikki Houghton, Simon Edwards, James Brimicombe, and Stephen Sutton

Rationale and aims. The aim of this pilot study was to assess the fidelity and engagement to a highly tailored medication adherence intervention delivered by Interactive Voice Response (IVR), as an adjunct to primary care consultations. The intervention is theory and evidence based, and messages include Behaviour Change Techniques (BCTs), are interactive and very brief (≥1 minute). Methodology and analysis. Twenty people with hypertension, presumed to be non-adherent, were recruited by three primary care practices, of whom 17 completed the one-month intervention. Mixed methods study generated data from call log files, inbound voice messages, and face-to-face follow up interviews. Quantitative data informed qualitative data analyses, and integrated into a thematic analysis. Results. On average, 29 calls were scheduled and 23 messages were received. Preliminary results from log files suggested that the intervention fidelity for the BCTs was: “implementation intentions” (4 scheduled /4 received), “information about health consequences” (4.41/5), “information about emotional consequences” (0.65/1), “report whether or not the behaviour was performed” (1.74/2), “habit formation” (19.58/24), “social reward” (1.4/2), and “social support (unspecified)” (2.29/3). Thematic analysis of the follow up interviews suggested that the IVR was easy to use: the tailored schedule of the calls, the personalisation, and the variation of the content were found to be particularly appealing, and were perceived to promote engagement with the intervention. Data suggested that the intervention messages increased awareness of the importance to take medications as prescribed, and facilitated habit formation and social support. Conclusions. Participants agreed on the need for, and the potential benefits of, an IVR intervention to support medication adherence between primary care consultations. Future research could usefully test the feasibility of a tailored IVR intervention to support medication adherence in the primary care.

References. Development and piloting of a highly tailored text and voice messaging intervention to support adherence to antihypertensive medications within the primary care setting (manuscript submitted for publication to JMIR).