TY - JOUR
T1 - Development and description of a theory-driven, evidence-based, complex intervention to improve adherence to treatment for tuberculosis in the UK: the IMPACT study
AU - Jones, Annie
AU - Horne, R
AU - White, Jacqui K.
AU - Costello, Trish
AU - Darvell, Marcia
AU - Karat, Aaron S.
AU - Kielmann, Karina
AU - Stagg, Helen R.
AU - Hill, Adam T
AU - Kunst, H.
AU - Campbell, Colin N.J.
AU - Lipman, Marc C I
N1 - Funding Information:
KK declares funding from the National Institute for Health Research, UK related to this grant. HRS declares funding from the Medical Research Council, UK, and National Institute for Health Research, UK, related to this grant. HRS declares other funding from the Latvian Society Against Tuberculosis (funding through Otsuka and Johnson and Johnson) and UiT The Arctic University of Norway for speaker engagements in the area of adherence to anti-tuberculosis medication. ASK reports salary support from a grant from the National Institute of Health Research (UK) and non-financial support from University College London (UK) during the conduct of the study. Outside the submitted work, ASK declares personal fees from The Aurum Institute (South Africa), the South African National TB Think Tank (funded by the Bill & Melinda Gates Foundation), Vital Strategies (Singapore; work funded by Bloomberg Philanthropies), The University of Cape Town (South Africa), the Center for Health Policies and Studies (Moldova), and the Edanz Group (Japan); and non-financial support from The Africa Health Research Institute (South Africa), Vital Strategies (Singapore), Kyoto University (Japan), and the Bill & Melinda Gates Foundation (USA). All other authors report no conflicts of interest.
Funding Information:
This research was conducted as part of the Intervening with a Manualised Package to Achieve treatment adherence in people with TB (IMPACT) study, supported by a National Institute for Health Research (NIHR; London, UK) Health Technology Assessment Programme (UK grant number 16/88/06). We thank the members of our Intervention Development Group who provided their expertise and input on the development of the intervention. We would also like to acknowledge In Tune For Life and UCL Creatives, who produced the animations and interactive booklet respectively. ASKJ and RH led the intervention development process. ASKJ led the drafting of this manuscript. JW, TC, MD, ASK, KK, HRS, ATH, CNJC and MCIL were all part of the intervention development group who led the design and creation of this work and contributed to the drafting of manuscript.
Funding Information:
This work was supported by the National Institute for Health and Care Research [Grant Number 16/88/06]. This research was conducted as part of the Intervening with a Manualised Package to Achieve treatment adherence in people with TB (IMPACT) study, supported by a National Institute for Health Research (NIHR; London, UK) Health Technology Assessment Programme (UK grant number 16/88/06). We thank the members of our Intervention Development Group who provided their expertise and input on the development of the intervention. We would also like to acknowledge In Tune For Life and UCL Creatives, who produced the animations and interactive booklet respectively. ASKJ and RH led the intervention development process. ASKJ led the drafting of this manuscript. JW, TC, MD, ASK, KK, HRS, ATH, CNJC and MCIL were all part of the intervention development group who led the design and creation of this work and contributed to the drafting of manuscript.
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2024
Y1 - 2024
N2 - Background: Tuberculosis (TB) has a significant treatment burden for patients, requiring at least six months of anti-TB treatment (ATT) with multiple medicines. Ensuring good adherence to ATT is central to global TB strategies, including those in high-income, low-TB incidence (HILI) settings. For adherence interventions to be successful and deliverable, they need to address the personal and environmental factors influencing patient and provider behaviour. Purpose: This paper describes the application of theory and research evidence to inform the design process of the IMPACT manualised intervention to support ATT adherence for adults with TB disease in the United Kingdom (UK). It also provides a full description of the resulting intervention. Methods: We synthesised findings from our formative research (qualitative and quantitative scoping reviews and patient and carer interviews) and supplemented these with clinic observations, a literature review, and healthcare provider interviews. Findings were mapped to the guiding theoretical framework (Perceptions and Practicalities Approach) which was operationalised to design the intervention components and content. An Intervention Development Group (IDG) of relevant stakeholders were consulted to adapt the intervention to local clinical settings. Results: The pragmatic, deliverable components and content for the IMPACT intervention included: (1) an enhanced, structured, risk assessment to systematically identify risk factors for non-adherence plus locally-adapted guidance to mitigate these; and (2) patient educational materials (an animated video and interactive patient booklet) about TB and its treatment, to communicate the need for treatment and address common concerns. Conclusions: Using a theory– and evidence– based approach incorporating stakeholder input, we have developed a multi-component, pragmatic, manualised intervention, which addresses patients’ personal barriers to adherence within local service resources to improve adherence to ATT within UK TB services.
AB - Background: Tuberculosis (TB) has a significant treatment burden for patients, requiring at least six months of anti-TB treatment (ATT) with multiple medicines. Ensuring good adherence to ATT is central to global TB strategies, including those in high-income, low-TB incidence (HILI) settings. For adherence interventions to be successful and deliverable, they need to address the personal and environmental factors influencing patient and provider behaviour. Purpose: This paper describes the application of theory and research evidence to inform the design process of the IMPACT manualised intervention to support ATT adherence for adults with TB disease in the United Kingdom (UK). It also provides a full description of the resulting intervention. Methods: We synthesised findings from our formative research (qualitative and quantitative scoping reviews and patient and carer interviews) and supplemented these with clinic observations, a literature review, and healthcare provider interviews. Findings were mapped to the guiding theoretical framework (Perceptions and Practicalities Approach) which was operationalised to design the intervention components and content. An Intervention Development Group (IDG) of relevant stakeholders were consulted to adapt the intervention to local clinical settings. Results: The pragmatic, deliverable components and content for the IMPACT intervention included: (1) an enhanced, structured, risk assessment to systematically identify risk factors for non-adherence plus locally-adapted guidance to mitigate these; and (2) patient educational materials (an animated video and interactive patient booklet) about TB and its treatment, to communicate the need for treatment and address common concerns. Conclusions: Using a theory– and evidence– based approach incorporating stakeholder input, we have developed a multi-component, pragmatic, manualised intervention, which addresses patients’ personal barriers to adherence within local service resources to improve adherence to ATT within UK TB services.
UR - http://www.scopus.com/inward/record.url?scp=85178229528&partnerID=8YFLogxK
U2 - 10.1080/21642850.2023.2277289
DO - 10.1080/21642850.2023.2277289
M3 - Article
SN - 2164-2850
VL - 12
JO - Health Psychology and Behavioral Medicine
JF - Health Psychology and Behavioral Medicine
IS - 1
M1 - 2277289
ER -
