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Potential normalization of an asthma mHealth intervention in community pharmacies: Applying a theory-based framework.

Authors
  • Kosse, Richelle C1
  • Murray, Elizabeth2
  • Bouvy, Marcel L3
  • de Vries, Tjalling W4
  • Stevenson, Fiona5
  • Koster, Ellen S6
  • 1 Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, the Netherlands. Electronic address: [email protected] , (Netherlands)
  • 2 Research Department of Primary Care and Population Health, University College London (UCL), London, United Kingdom. Electronic address: [email protected] , (United Kingdom)
  • 3 Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, the Netherlands. Electronic address: [email protected] , (Netherlands)
  • 4 Department of Paediatrics, Medical Centre Leeuwarden (MCL), Leeuwarden, the Netherlands. Electronic address: [email protected] , (Netherlands)
  • 5 Research Department of Primary Care and Population Health, University College London (UCL), London, United Kingdom. Electronic address: [email protected] , (United Kingdom)
  • 6 Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, the Netherlands. Electronic address: [email protected] , (Netherlands)
Type
Published Article
Journal
Research in social & administrative pharmacy : RSAP
Publication Date
Feb 01, 2020
Volume
16
Issue
2
Pages
195–201
Identifiers
DOI: 10.1016/j.sapharm.2019.05.004
PMID: 31109820
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Effective mobile health (mHealth) interventions have been developed to support patients with their medication use, however to date few are widely used in pharmacy practice. Normalization of an intervention is essential to have a population impact, which is defined as 'the process of getting a new intervention into routine practice'. The aim of this study was to assess the normalization potential of a complex mHealth intervention for adolescents with asthma (ADolescent Adherence Patient Tool; ADAPT) in community pharmacy practice. The Normalization Process Theory (NPT), a sociological action theory, was retrospectively applied to study the normalization potential of ADAPT. NPT explains factors that promote or hinder implementation, embedding, and integration of new interventions in clinical practice. Evaluation data (structured interviews and questionnaires) of 23 pharmacists who used the ADAPT intervention were used for this study. Pharmacists understood the purpose of the ADAPT intervention and were prepared to undertake the necessary work of implementation. However changes at different levels are needed to support full normalization, such as changes in the intervention itself and changes in the pharmacist's work flow. The potential for normalization could also be enhanced by the use of product champions and appropriate reimbursement guidelines, to ensure uptake of the intervention by other pharmacists. Support from professional bodies for the use of mHealth could also promote normalization. Normalization of mHealth is a complex continuous process. The ADAPT intervention has the potential to be normalized in community pharmacy practice, but full normalization would require changes in both daily pharmacy practice and reimbursement models. Copyright © 2019 Elsevier Inc. All rights reserved.

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