Many people with hypertension do not take their medication as prescribed. This reduces how well such treatment works, leading to increased heart attacks and strokes. It also means that a lot of medicines are wasted, which costs the NHS several hundred million pounds a year.
Health care practitioners can support patients in taking their medication, but they have limited time and their time is expensive. There is therefore a need for low-cost interventions that support patients to take their tablets as prescribed. A promising approach is to use digital interventions such as text messaging or smartphone ‘apps’.
This programme will develop a digital intervention, in combination with Very Brief Intervention (VBI) from a practice nurse or healthcare assistant, to support treatment adherence for patients with hypertension and co-morbidities.
Aims and objectives:
- To develop a scalable low-cost intervention to support medication adherence in people prescribed treatment for hypertension in primary care. The intervention will consist of two components: (i) a very brief intervention delivered by a practice nurse or healthcare assistant that ‘signposts’ the patient to (ii) a digital intervention designed to provide ongoing support between practice visits.
- To evaluate the acceptability and feasibility of the two-component intervention and the feasibility of conducting a (cost-) effectiveness trial.
- To provide precise and robust estimates of the effectiveness and cost-effectiveness of the intervention compared with usual care.
- To develop an economic model of cost-effectiveness of medication adherence interventions.
- To inform a decision on whether to implement the two-component intervention in primary care.
For more information about PAM Programme, please contact firstname.lastname@example.org
This programme is funded by the National Institute for Health Research (NIHR) under the Programme Grants for Applied Research programme (RP-PG-0615-20013).
Publications and Dissemination
(2022). A Systematic Review and Meta-analysis of Face-to-face Medication Adherence Interventions for Patients with Long Term Health Conditions.. Annals of Behavioral Medicine, kaac010. https://doi.org/10.1093/abm/kaac010
Chilala, CI., Kassavou, A., Sutton, S. (2022). Effectiveness of Remote Behavioral Interventions Facilitated by Health Care Providers at Improving Medication Adherence in Cardiometabolic Conditions. A Systematic Review and Meta-analysis. Annals of Behavioral Medicine (in press)
Kassavou, A., Wang, M., Mirzaei, V. et al . (2022). Does App-based Self-monitoring of Hypertension-related Behaviours Reduce High Blood Pressure? : A Systematic Literature Review with Meta-analyses. JMIR (in press)
Kassavou, A., Mirzaei, V., Shpendi, S. et al. The feasibility of the PAM intervention to support treatment-adherence in people with hypertension in primary care: a randomised clinical controlled trial. Sci Rep 11, 8897 (2021). doi.org/10.1038/s41598-021-88170-2
Akhter, K., Sutton, S., Kassavou, A. Exploring views and recommendations from travellers and their representative officers about components of an acceptable digital medication adherence intervention: A Patient and Public Involvement exercise. European Health Psychologist, volume 21, issue 6 (2021) https://ehps.net/ehp/index.php/contents/article/view/3354
1-3 November 2021 – UCL Centre for Behaviour Change online conference, London
- Presentation: Qualitative study – acceptability and feasibility of PAM intervention (workstream 3)
- Poster: PAM protocol for randomised controlled trial (workstream 4)
- Poster: PAM smartphone app sub-study
7 June 2021 – International Congress of Behavioural Medicine (ICBM), online conference, Glasgow
- Poster: PAM sub-study – uptake and engagement of the PAM smartphone app
- Presentation: PAM feasibility Randomised Controlled Trial
18 September 2020 – UCL Centre for Behaviour Change online conference, London
Two posters presenting findings from the following PAM sub-studies:
- Workstream 3 – feasibility Randomised Controlled Trial
- Workstream 2 – pre-testing study
10 September 2020 – Society for Social Medicine and Population Health, 64th Annual Scientific Meeting, Cambridge
Akhter, K. et al. A systematic review of face-to-face medication adherence interventions for patients with long term health conditions. (Poster presentation)
22 January 2020 – Society for Academic Primary Care (SAPC) South East Conference, Cambridge
Two presentations from the PAM programme:
- A’Court C, Kassavou K, Brimicombe J, Chauhan J, Mascolo C, Sutton S. Assessing the acceptability of a text messaging service and smartphone app to support patient adherence to medications prescribed for high blood pressure (Poster – Workstream 2)
- Kassavou K, Mirzaei V, Brimicombe J, Chauhan J, Hafiz A, Mascolo C, Sutton S. Programme on Adherence to Medication. Feasibility of a very brief face to face intervention, followed by a text message and/or app intervention to support medication adherence in people prescribed treatment for hypertension in primary care (Presentation – Workstream 3)
21st October 2019 – Cambridge Institute of Public Health Annual Lecture, Cambridge
Van Emmenis M, Jamison J, Eborall H, Kassavou K, A’ Court C, Chauhan J, Servia S, Sutton S. Patient and practitioner views on an intervention to support medication adherence in patients with hypertension. (Poster presentation)
6 September 2019 – European Health Psychology Society conference, Dubrovnik
Two poster presentations from the PAM programme:
- Kassavou K, A’ Court C, Akhter K, Mirzaei V, Brimicombe J, Chauhan J, Mascolo C, Sutton S. A brief face-to-face intervention, followed by a text message and/or smartphone app. Acceptability of a two component intervention for medication adherence in patients with hypertension. (Workstream 2)
- Van Emmenis M, Jamison J, Eborall H, Kassavou K, A’ Court C, Chauhan J, Servia S, Sutton S. Patient and practitioner views on an intervention to support medication adherence in patients with hypertension. (Workstream 1)
24 March 2019 – University of Cambridge Science Festival
The PAM team held an interactive stall with family-friendly games, quizzes and prizes at the University of Cambridge Science Festival. It was a great opportunity to showcase why and how we do our research and to get feedback from members of the public. Read about our experience at the Science Festival on the NIHR School for Primary Care Research blog here.
24-25 January 2019 – SAPC SE Regional Meeting, Madingley
- Kassavou, K, A’ Court, C, Akhter, K, Mirzaei, V. Using digital interventions to support medication adherence in primary care (Workshop). For more information on this interactive workshop, see here.
- A’ Court, C, Kassavou, K. Scalable low-cost interventions to support medication adherence in people prescribed medication for hypertension in primary care (presentation)
24-26 October 2018 – Royal College of General Practitioners Annual Conference, Liverpool
Armitage, L., Kassavou, K., Sutton, S., Mobile device applications to support medication adherence: a systematic review with meta-analysis (Poster presentation)
24th August 2018 – European Health Psychology Society conference, Galway
Armitage, L., Kassavou, K., Sutton, S., The Use of Mobile Device Applications to Support Medication Adherence: Systematic Review and Meta-analysis. (Poster presentation)