Tailored voice messages in automated phone calls to patients could successfully prompt patients to take medicines as prescribed, according to a study of patients and nurses working in GP surgeries, published as ‘Reasons for non-adherence to cardiometabolic medications, and acceptability of an interactive voice response intervention in patients with hypertension and type 2 diabetes in primary care: a qualitative study‘ in BMJ Open.
Up to 40% of prescribed medicines are not actually taken by patients, resulting in less effective treatments and increased NHS costs. This is particularly important for people who use health care services regularly, such as patients with Type 2 diabetes or high blood pressure.
This new qualitative study, by Dr Katerina Kassavou and Professor Stephen Sutton at the University of Cambridge, explored the reasons why patients don’t take prescribed medicines. The researchers looked at current action to address the problem and tested the acceptability of an interactive voice response (IVR) system to provide phone advice and support to patients, between primary care consultations. They interviewed a small group of patients with high blood pressure, type 2 diabetes, or both conditions. They also interviewed a small group of nurses working in GP surgeries. Based on participants’ input, the researchers developed a new IVR system and then tested sections of the new system directly with patients.
The findings illustrate that patients have varying beliefs about taking medicines and their own ability to cope with their underlying conditions.
One size doesn’t fit all really does it? Everybody’s different and what works for one person doesn’t always work for another”
– patient, interviewed for this study
The complexity of medicine regimes were important as well.
I often think all these six going down my throat all in one go”
– patient, interviewed for this study
Nurses reported time constraints and explained a range of challenges they experience in seeking to address each patient’s different reasons for non-adherence.
Sometimes patients say things to you and then you find out when you actually check their medications or prescriptions that they’re not doing what you asked them to do really .. actually when it comes to it, it’s very difficult to change some lifestyle”
– practice nurse, interviewed for this study
Both patients and nurses had favourable views on an automated, telephone-based intervention and recommended messages to be tailored to each patient’s needs for taking medicines. Patients expressed positive feedback about using elements of the new IVR. They liked the voice delivering the messages and the voice recognition software. They preferred messages that are tailored to their conditions, that included “information about health consequences”, or just simple reminders.
It feels like somebody who’s closer to you”
– patient, interviewed for this study
The interactive element of the interventions seemed to be most useful for people to request support when they had missed their tablets. The researchers concluded that including elements of personalisation in voice messages to patients could increase uptake and initial engagement with this type of intervention.
The research was funded by School for Primary Care Research (SPCR) NIHR.
Find out more
Link to the research paper in BMJ Open
This report is independent research by the National Institute for Health Research. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health