Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub
Abstract 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 behavi...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-020-00739-2 |
| _version_ | 1818453046716268544 |
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| author | M. A. Arden M. Hutchings P. Whelan S. J. Drabble D. Beever J. M. Bradley D. Hind J. Ainsworth C. Maguire H. Cantrill A. O’Cathain M. Wildman |
| author_facet | M. A. Arden M. Hutchings P. Whelan S. J. Drabble D. Beever J. M. Bradley D. Hind J. Ainsworth C. Maguire H. Cantrill A. O’Cathain M. Wildman |
| author_sort | M. A. Arden |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-14T21:32:46Z |
| format | Article |
| id | doaj.art-cb4274c996c8421ca75897284c268bab |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-12-14T21:32:46Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-cb4274c996c8421ca75897284c268bab2022-12-21T22:46:39ZengBMCPilot and Feasibility Studies2055-57842021-01-017111810.1186/s40814-020-00739-2Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHubM. A. Arden0M. Hutchings1P. Whelan2S. J. Drabble3D. Beever4J. M. Bradley5D. Hind6J. Ainsworth7C. Maguire8H. Cantrill9A. O’Cathain10M. Wildman11Centre for Behavioural Science and Applied Psychology, Sheffield Hallam UniversitySheffield Adult Cystic Fibrosis Unit Sheffield Teaching Hospitals NHS Foundation Trust, Northern General HospitalHealth eResearch Centre—Farr Institute, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science CentreSchool of Health and Related Research, University of SheffieldClinical Trials Research Unit, University of SheffieldCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s UniversityClinical Trials Research Unit, University of SheffieldHealth eResearch Centre—Farr Institute, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science CentreClinical Trials Research Unit, University of SheffieldClinical Trials Research Unit, University of SheffieldSchool of Health and Related Research, University of SheffieldSheffield Adult Cystic Fibrosis Unit Sheffield Teaching Hospitals NHS Foundation Trust, Northern General HospitalAbstract 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.https://doi.org/10.1186/s40814-020-00739-2Cystic fibrosisAdherenceIntervention developmentBehaviour change wheelPerson-based approachDigital intervention |
| spellingShingle | M. A. Arden M. Hutchings P. Whelan S. J. Drabble D. Beever J. M. Bradley D. Hind J. Ainsworth C. Maguire H. Cantrill A. O’Cathain M. Wildman Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub Pilot and Feasibility Studies Cystic fibrosis Adherence Intervention development Behaviour change wheel Person-based approach Digital intervention |
| 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 | Cystic fibrosis Adherence Intervention development Behaviour change wheel Person-based approach Digital intervention |
| url | https://doi.org/10.1186/s40814-020-00739-2 |
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