Two-way Automated Text Messaging Support From Community Pharmacies for Medication Taking in Multiple Long-term...

Area of Science:

• Health Services Research
• Digital Health
• Patient Engagement

Background:

• Digital communication technologies show potential for supporting medication adherence, but their integration with non-digital elements requires further investigation.
• Community pharmacies represent a novel setting for delivering digital health interventions, particularly for patients managing multiple long-term conditions.
• Stakeholder involvement in designing complex healthcare interventions is crucial but often underexplored, with human-centered design (HCD) offering a potential framework.

Purpose of the Study:

• To design a novel community pharmacy text messaging intervention aimed at improving medication use among patients with multiple long-term conditions.
• To incorporate patient and healthcare professional perspectives throughout the intervention design process within primary care settings.

Main Methods:

• Human-centered design (HCD) was employed to map the intervention pathway and identify key design questions for stakeholders.
• Six intervention prototypes were developed, and feedback was gathered using a modified Nominal Group Technique, followed by web-based questionnaire ranking.
• Qualitative data from nominal group meetings were analyzed using a framework approach, and feedback was prioritized to inform design revisions.

Main Results:

• A total of 30 participants (21 healthcare professionals, 9 patients) provided input, with a 57% response rate to the ranking questionnaire.
• Fifty-one proposed changes were generated, with 27 (53%) incorporated into the subsequent design phase based on high-priority rankings.
• Key refinements included tailoring text message content, enhancing patient information materials, and optimizing pharmacist consultation structure, indicating good intervention acceptability.

Conclusions:

• Human-centered design (HCD) combined with the Nominal Group Technique provides a successful framework for iterative design and stakeholder feedback collection.
• This approach is particularly effective for complex interventions integrating digital and non-digital components in settings like community pharmacies.
• Early and prioritized multiperspective feedback minimizes research waste and informs the development and testing of patient-centered healthcare interventions.