Supporting General Practitioners and people with hypertension to maximise medication use to control blood pressure: the contribution of Collective Intelligence to the development of the 'Maximising Adherence, Minimising Inertia' (MIAMI) intervention.

IF 2.4 Q2 PSYCHOLOGY, CLINICAL Health Psychology and Behavioral Medicine Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI:10.1080/21642850.2024.2404038
Eimear C Morrissey, Owen M Harney, Michael J Hogan, Patrick J Murphy, Louise O'Grady, Molly Byrne, Monica Casey, Sinead Duane, Hannah Durand, Peter Hayes, Caroline McDevitt, Denis Mockler, Martin Murphy, Patrick Towers, Andrew W Murphy, Gerard J Molloy
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Abstract

Background: Hypertension remains one of the most important modifiable risk factors for stroke and heart disease. Anti-hypertensive medications are effective, but are often not used to maximum benefit. Sub-optimal dosing by prescribers and challenges with medication-taking for patients remain barriers to effective blood pressure control.

Objectives: We aimed to systematically develop a theory-based complex intervention to support General Practitioners (GPs) and people with hypertension to maximise medication use to control blood pressure.

Methods: We used the three-phase Behaviour Change Wheel (BCW) as the overarching intervention development framework. Collective Intelligence methodology was used to operationalise the stakeholder input to Phases 2 and 3 of the BCW. This took the form of a Collective Intelligence workshop with 19 stakeholders from diverse backgrounds including lived experience, general practice, nursing, pharmacy and health psychology. Techniques such as barrier identification, idea-writing and scenario-based design were used to generate possible intervention options. Intervention options were then selected and refined using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria and guidance from the MIAMI Public and Patient Involvement Panel.

Results: The finalised MIAMI intervention consists of both GP and patient supports. GP supports include a 30-minute online training, information booklet and consultation guide (drop-down menu) embedded within the patient electronic health system. Patient supports include a pre-consultation plan, website, and a structured GP consultation with results from an Ambulatory Blood Pressure Monitor and urine chemical adherence test. The intervention components have been mapped to the intervention functions of the BCW and Behaviour Change Technique Ontology.

Conclusion: Collective Intelligence offered a novel method to operationalise stakeholder input to Phases 2 and 3 of the BCW. The MIAMI intervention is now at pilot evaluation stage.

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支持全科医生和高血压患者最大限度地使用药物控制血压:集体智慧对开发 "最大限度地坚持用药,最大限度地减少惰性"(MIAMI)干预措施的贡献。
背景:高血压仍然是中风和心脏病最重要的可改变风险因素之一。抗高血压药物是有效的,但往往不能发挥最大疗效。处方者的用药剂量不够理想以及患者在服药方面遇到的挑战仍然是有效控制血压的障碍:我们旨在系统地开发一种基于理论的综合干预措施,以支持全科医生(GP)和高血压患者最大限度地使用药物控制血压:方法:我们使用三阶段行为改变轮(BCW)作为总体干预开发框架。集体智慧"(Collective Intelligence)方法用于将利益相关者对 BCW 第二和第三阶段的意见进行操作化。该方法采用了集体智慧研讨会的形式,来自生活经验、全科实践、护理、药学和健康心理学等不同背景的 19 名利益相关者参加了研讨会。研讨会采用了障碍识别、构思写作和情景设计等技术来生成可能的干预方案。然后,根据可接受性、实用性、有效性、可负担性、副作用和公平性(APEASE)标准以及 MIAMI 公众和患者参与小组的指导,对干预方案进行选择和完善:最终确定的 MIAMI 干预措施包括全科医生支持和患者支持。全科医生支持包括 30 分钟的在线培训、信息手册以及嵌入患者电子健康系统的咨询指南(下拉菜单)。患者支持包括会诊前计划、网站和全科医生结构化会诊,以及动态血压监测仪和尿液化学依从性测试的结果。干预组件已与 BCW 和行为改变技术本体的干预功能进行了映射:结论:"集体智慧 "提供了一种新颖的方法,将利益相关者对《巴塞尔公约》第 2 和第 3 阶段的意见可操作化。MIAMI干预目前正处于试点评估阶段。
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来源期刊
CiteScore
3.50
自引率
3.70%
发文量
57
审稿时长
24 weeks
期刊介绍: Health Psychology and Behavioral Medicine: an Open Access Journal (HPBM) publishes theoretical and empirical contributions on all aspects of research and practice into psychosocial, behavioral and biomedical aspects of health. HPBM publishes international, interdisciplinary research with diverse methodological approaches on: Assessment and diagnosis Narratives, experiences and discourses of health and illness Treatment processes and recovery Health cognitions and behaviors at population and individual levels Psychosocial an behavioral prevention interventions Psychosocial determinants and consequences of behavior Social and cultural contexts of health and illness, health disparities Health, illness and medicine Application of advanced information and communication technology.
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