JMIR Publications

ABSTRACT

Background:

Reviews of digital communication technologies suggest that they can be effective at supporting medication taking, however their use alongside non-digital components is unclear. We also wanted to explore the delivery of a digital communication intervention in the relatively novel setting of community pharmacies and how such an intervention might be delivered for patients with multiple long-term conditions. This meant that despite the large number of intervention examples available in the literature, design questions remained which we wanted to explore with key stakeholders. Examples of how to involve stakeholders in the design complex healthcare interventions are lacking, however Human Centered Design (HCD) has been suggested as a potential approach.

Objective:

To design a new community pharmacy text messaging intervention to support medication taking for multiple long-term conditions, with patient and healthcare professional stakeholders in primary care.

Methods:

Human Centered Design was used to map the intervention ‘journey’ and identify design questions to explore with patients and healthcare professionals. Six prototypes were developed to communicate the intervention concept and a modified version of Nominal Group Technique was used to gather feedback. Nominal group meetings generated qualitative data using questions about what aspects participants liked about each prototype and any suggested changes. The discussion was analyzed using the Framework approach to transform feedback into statements. These statements were then ranked using an online questionnaire to establish consensus about what elements of the design were valued by stakeholders and what changes to the design were most important.

Results:

A total of 30 participants provided feedback on the intervention design concept over five nominal group meetings (n=21 healthcare professionals, n=9 patients) with a 57% response rate to the ranking questionnaire. 51 proposed changes to the intervention were generated from the Framework analysis. Of these, 27 (53%) were incorporated into the next design stage, focusing on changes which were the highest ranked. These included suggestions for how text message content might be tailored, patient information materials, and the structure for a pharmacist consultation. All aspects participants liked were retained in the future design and provided evidence that the proposed intervention concept had good acceptability.

Conclusions:

Human Centered Design incorporating NGT is an appropriate and successful approach for obtaining feedback from key stakeholders, as part of an iterative design process. It was particularly helpful for our intervention which combined digital and non-digital components for delivery in the novel setting of a community pharmacy. This approach enabled the collection and prioritization of useful multi-perspective feedback to inform further development and testing of our intervention. This model has the potential to also minimize research waste by gathering feedback early in the complex intervention design process. Clinical Trial: Not applicable.