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Improving medication adherence in stroke survivors: the intervention development process.

Elise Crayton1,2, Alison J Wright3, Mark Ashworth4

  • 1Faculty of Life Sciences and Medicine, School of Population Health & Environmental Sciences, King's College London, London, UK. elise.crayton@kcl.ac.uk.

BMC Health Services Research
|October 13, 2018
PubMed
Summary
This summary is machine-generated.

Developing theory-driven interventions for stroke survivors improves medication adherence. Key behavior change techniques (BCTs) like Habit Formation and Action Planning are identified as feasible and effective for enhancing adherence.

Keywords:
Health behaviorIntervention developmentMedication adherenceSecondary preventionStroke

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Area of Science:

  • Behavioral Science
  • Public Health
  • Stroke Medicine

Background:

  • Medication adherence in stroke survivors is suboptimal despite effective risk factor treatments.
  • Existing interventions often lack theoretical grounding, limiting their effectiveness in behavior change.
  • Theory-driven and evidence-based approaches are crucial for enhancing intervention effectiveness and implementation.

Purpose of the Study:

  • To identify appropriate components for a theory-driven and evidence-based medication adherence intervention for stroke survivors.
  • To leverage established frameworks for systematic intervention development.

Main Methods:

  • Utilized the Behaviour Change Wheel (BCW) for intervention development.
  • Mapped determinants of medication adherence to the Theoretical Domains Framework (TDF).
  • Applied APEASE criteria to evaluate and select behavior change techniques (BCTs) within the UK National Health Service (NHS) context.

Main Results:

  • Identified five intervention functions and five policy categories as potential intervention options.
  • Reduced an initial pool of 21 BCTs to 11 feasible and targeted components, including Habit Formation, Information about Health Consequences, and Action Planning.
  • Selected BCTs directly address underlying determinants of medication adherence in stroke survivors.

Conclusions:

  • A systematic, theory-driven approach using the BCW effectively identified appropriate intervention components.
  • Habit Formation, Information about Health Consequences, and Self-monitoring of Behaviour are promising BCTs for stroke medication adherence within the NHS.
  • This intervention development methodology is generalizable to other chronic conditions and behavior change areas.