A Research Proposal to Develop a Healthcare Professionals Manual to promote Community-based Medication Adherence in Inflammatory Bowel Disease

TY - CONF

T1 - A Research Proposal to Develop a Healthcare Professionals Manual to promote Community-based Medication Adherence in Inflammatory Bowel Disease

AU - King, Kathryn

AU - Jalal, Zahraa

AU - Chalder, Trudie

AU - Norton, Christine Susan

PY - 2019/4/9

Y1 - 2019/4/9

N2 - Introduction: Inflammatory Bowel Disease (IBD) applies to the chronic conditions of ulcerative colitis and Crohn’s disease, associated with inflammation of the digestive system. Typical symptoms range from mild to severe, may fluctuate over time and can be intestinal: abdominal pain and bloating, recurring or bloody diarrhoea, and extra-intestinal: anaemia, loss of appetite and weight loss. Both Crohn’s disease and ulcerative colitis have been related to colon cancer, urinary complications, anxiety and depression. Currently an estimated 62,000 people in the UK are thought to be effected by IBD, with a prevalence of 0.5–1%. The increasing incidence, incurable nature and young age of onset means that treatment of IBD has significant cost implications to the NHS of over £470 million. Treatment for IBD includes dietary and lifestyle changes, immunosuppressives, biologics and steroids, demanding a high level of adherence, to both pharmacological and non-pharmacological approaches. Adverse clinical outcomes can result from non-adherence to medical treatment for IBD including increased flare ups and disease activity. Adherence promotion can help to alleviate the physiological and psychological effects of this long-term condition whilst promoting treatment cost-effectiveness. Aim: The aim of this proposal is to plan and develop a manual for healthcare professionals to use with patients with IBD in the community, in order to help promote adherence to IBD medications. Methods: A Manual Development Group (MDG) will be selected including experts in pharmacy, behaviour change, nursing, IBD medicine and IBD patient advocacy. A logical model will be used to develop the Manual, to help identify the problem, influences on behaviour, the solution, preparatory variables and benefits to the patients and the NHS. The TIDieR checklist (Hoffman et al, 2014), will be followed as a guide for improving and standardising the development of interventions combined with theoretical background of the Necessity and Concerns framework (Horne et al, 2013). Preparatory research with the target population and user testing will be conducted in order to maximise patient and public involvement and guide manual content and style. Once published, the Manual will be piloted within a community-based clinical setting in order to validate its use. Results: The TIDieR checklist will provide structure in manual development, through addressing the points of: Why; Theory? What; Procedures and materials? Who? When and How much? How and where? Tailoring and Modifications? Discussion: The proposed manual will be created to provide an aid to support adherence promotion to IBD medications within the community, which can be used by Pharmacists and other healthcare professionals with patients. The manual can be taken away by the patient to review in their own time, following their healthcare consultation and shown to family and friends as a means of information dissemination and generating additional support for the patient. The effectiveness of the manual cannot yet be assessed until it is finalised and tested. If found to be efficient in providing additional adherence support for IBD patients, the MDG plan to develop further materials, such as an electronic application, as well as a more complex, therapeutic intervention taking place.

AB - Introduction: Inflammatory Bowel Disease (IBD) applies to the chronic conditions of ulcerative colitis and Crohn’s disease, associated with inflammation of the digestive system. Typical symptoms range from mild to severe, may fluctuate over time and can be intestinal: abdominal pain and bloating, recurring or bloody diarrhoea, and extra-intestinal: anaemia, loss of appetite and weight loss. Both Crohn’s disease and ulcerative colitis have been related to colon cancer, urinary complications, anxiety and depression. Currently an estimated 62,000 people in the UK are thought to be effected by IBD, with a prevalence of 0.5–1%. The increasing incidence, incurable nature and young age of onset means that treatment of IBD has significant cost implications to the NHS of over £470 million. Treatment for IBD includes dietary and lifestyle changes, immunosuppressives, biologics and steroids, demanding a high level of adherence, to both pharmacological and non-pharmacological approaches. Adverse clinical outcomes can result from non-adherence to medical treatment for IBD including increased flare ups and disease activity. Adherence promotion can help to alleviate the physiological and psychological effects of this long-term condition whilst promoting treatment cost-effectiveness. Aim: The aim of this proposal is to plan and develop a manual for healthcare professionals to use with patients with IBD in the community, in order to help promote adherence to IBD medications. Methods: A Manual Development Group (MDG) will be selected including experts in pharmacy, behaviour change, nursing, IBD medicine and IBD patient advocacy. A logical model will be used to develop the Manual, to help identify the problem, influences on behaviour, the solution, preparatory variables and benefits to the patients and the NHS. The TIDieR checklist (Hoffman et al, 2014), will be followed as a guide for improving and standardising the development of interventions combined with theoretical background of the Necessity and Concerns framework (Horne et al, 2013). Preparatory research with the target population and user testing will be conducted in order to maximise patient and public involvement and guide manual content and style. Once published, the Manual will be piloted within a community-based clinical setting in order to validate its use. Results: The TIDieR checklist will provide structure in manual development, through addressing the points of: Why; Theory? What; Procedures and materials? Who? When and How much? How and where? Tailoring and Modifications? Discussion: The proposed manual will be created to provide an aid to support adherence promotion to IBD medications within the community, which can be used by Pharmacists and other healthcare professionals with patients. The manual can be taken away by the patient to review in their own time, following their healthcare consultation and shown to family and friends as a means of information dissemination and generating additional support for the patient. The effectiveness of the manual cannot yet be assessed until it is finalised and tested. If found to be efficient in providing additional adherence support for IBD patients, the MDG plan to develop further materials, such as an electronic application, as well as a more complex, therapeutic intervention taking place.

KW - Inflammatory Bowel Disease

KW - IBD

KW - Adherence

KW - Intervention

KW - Manual

M3 - Poster

T2 - Crossing Cultural Boundaries: Optimising Communications for Future Care

Y2 - 9 April 2018 through 9 April 2019

ER -