Implementation of a Real-Time Medication Intake Monitoring Technology Intervention in Community Pharmacy Settings: A Mixed-Method Pilot Study

Abstract

Innovative dispensing products offering real-time medication intake monitoring are being developed to address medication non-adherence. However, implementation of these interventions within the workflow of a community pharmacy is unknown. The purpose of this study was to explore factors affecting implementation of a real-time adherence-monitoring, multidose-dispensing system in community pharmacies. A mixed-method study was conducted with pharmacy staff, who packaged and dispensed medications in smart multidose packages and monitored real-time medication intake via web-portal. Pharmacy staff participated in semi-structured interviews. The Technology Acceptance Model, Theory of Planned Behaviour and Capability, Opportunity, Motivation, Behaviour Model informed the interview guide. Interview transcripts were analyzed thematically and findings were mapped back to the frameworks. The usability was assessed by the System Usability Scale (SUS). Three pharmacists and one pharmacy assistant with a mean of 19 years of practice were interviewed. Three themes and 12 subthemes were generated. Themes included: pharmacy workflow factors, integration factors, and pharmacist-perceived patient factors. The mean SUS was found to be 80.63. Products with real-time adherence monitoring capabilities are valued by pharmacists. A careful assessment of infrastructure—including pharmacy workload, manpower and financial resources—is imperative for successful implementation of such interventions in a community pharmacy setting.

Exploring the Value of Real-Time Medication Adherence Monitoring: A Qualitative Study

“…Pharmacists and pharmacy owners valued that these products might also potentially improve or enhance their role in the medication management process as they would have more insight about a patient’s medication taking due to the accessibility of real-time medication adherence and it might help them develop personalized adherence strategies for their patients in a timely manner. Similar findings were reported by a study based in community pharmacies, which determined that pharmacists felt that having access to real-time medication intake data improved their patient interaction and helped them initiate dialogues about non-adherence based on real-time evidence [ 21 ]. Another study of older adults using a smart blister pack for medication management reported that the reminder function of the smart product made patients more aware of their medication routine and impacted their medication-taking behavior [ 16 ].…”

“…The amount of data collected by these products may cause challenges for healthcare providers related to data management and their ability to act on the data to support their patients’ medication taking in a timely manner. Previous research has reported similar concerns from community pharmacists [ 21 ]. These groups discussed the need to outline and manage patients’ expectations concerning their response to these data.…”

“…A growing body of research is exploring the usability, user experience, and workload involved in using these products by various patient populations, including older adults and people with chronic diseases [ 16 , 17 , 18 , 19 ]. Studies have also explored the views and preferences of healthcare providers about these products and factors affecting the offering of such products for patients [ 20 , 21 , 22 ]. Although these studies reported participants’ perspectives on smart medication adherence products, none of them explored participants’ values related to the availability of real-time monitoring data in a detailed manner.…”

Application of behavioural theories, models, and frameworks in pharmacy practice research based on published evidence: a scoping review

“…Tables 2, 3, 4 present details describing the aim of the included studies; the majority of the studies were investigations of pharmacy complex interventions, as defined by the UK MRC framework. These included investigations to explore pharmacists' involvement in various initiatives such as medicines optimization services [27], immunization clinics [28], pharmacist prescribing [29], falls prevention [30], medicines management services [31][32][33][34][35], and pharmacogenomics testing [36,37].…”

“…Studies that combined multiple theories/models/frameworks cited their potential synergies as the chief driver for their combined use (n = 3) [35,36,72] however six studies did not provide a rationale for the combination [37,41,42,[73][74][75].…”