Feasibility study for supporting medication adherence for adults with cystic fibrosis: mixed-methods process...

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Digital Health

Background:

• Medication adherence is crucial for managing cystic fibrosis (CF).
• Adherence support interventions aim to improve treatment outcomes in people with CF (PWCF).
• Process evaluations are essential for refining interventions before wider implementation.

Purpose of the Study:

• To assess the feasibility and acceptability of an adherence support intervention for PWCF.
• To identify barriers and facilitators to implementing the intervention in a clinical setting.
• To inform modifications for optimizing the intervention's effectiveness.

Main Methods:

• A process evaluation was conducted in two UK CF centers.
• The intervention involved a nebulizer with data capabilities and support from trained interventionists over five months.
• Data were collected via interviews, questionnaires, fidelity assessments, and device analytics.

Main Results:

• Interventionists found the training positive but faced challenges with clinic space and time, leading to fewer visits.
• Inaccurate prescription data and device connectivity issues affected adherence data interpretation.
• Fidelity assessments indicated 100% content quality but variable delivery quality (60%-92%).

Conclusions:

• The adherence support intervention is feasible and acceptable for PWCF after 14 procedural modifications.
• Addressing identified barriers is key to successful implementation and improved medication adherence.
• Refined intervention procedures enhance the potential for supporting adherence in CF management.