Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative

Author:

Girling Carla1ORCID,Davids India1ORCID,Totton Nikki1,Arden Madelynne A.2,Hind Daniel1,Wildman Martin J.3

Affiliation:

1. Clinical Trials Research Unit University of Sheffield Sheffield UK

2. Department of Psychology, Sociology and Politics Sheffield Hallam University Sheffield UK

3. Sheffield Adult Cystic Fibrosis Unit Sheffield Teaching Hospitals NHS Foundation Trust Northern General Hospital Sheffield UK

Abstract

AbstractBackgroundMedication adherence data are an important quality indicator in cystic fibrosis (CF) care, yet real‐time objective data are not routinely available. An online application (CFHealthHub) has been designed to deliver these data to people with CF and their clinical team. Adoption of this innovation is the focus of an National Health Service England‐funded learning health system and Quality Improvement Collaborative (QIC). This study applies the capability, opportunity, and motivation model of behavior change to assess whether the QIC had supported healthcare professionals' uptake of accessing patient adherence data.MethodThis was a mixed‐method study, treating each multidisciplinary team as an individual case. Click analytic data from CFHealthHub were collected between January 1, 2018, and September 22, 2019. Thirteen healthcare practitioners participated in semi‐structured interviews, before and after establishing the QIC. Qualitative data were analyzed using the behavior change model.ResultsThe cases showed varied improvement trajectories. While two cases reported reduced barriers, one faced persistent challenges. Participation in the QIC led to enhanced confidence in the platform's utility. Reduced capability, opportunity, and motivation barriers correlated with increased uptake, demonstrating value in integrating behavior change theory into QICs.ConclusionQICs can successfully reduce barriers and enable uptake of e‐health innovations such as adherence monitoring technology. However, ongoing multi‐level strategies are needed to embed changes. Further research should explore sustainability mechanisms and their impact on patient outcomes.

Publisher

Wiley

Reference43 articles.

1. CharmanS McClenaghanE CosgriffR LeeA CarrS.UK Cystic Fibrosis Registry Annual data report 2018.2019. Accessed May 11 2021.https://www.cysticfibrosis.org.uk/sites/default/files/2020-12/2018

2. Cystic fibrosis

3. Dornase alfa for cystic fibrosis;Yang C;Cochrane Database Syst Rev,2016

4. Adherence pattern to study drugs in clinical trials by patients with cystic fibrosis

5. Accurate Assessment of Adherence

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