((B-055)) (B-055) Evaluating the Implementation of Medication Adherence Interventions by Pharmacy-driven Living Labs in the Netherlands

Background: Four pharmacy-driven living labs implemented consultation-based medication adherence interventions in daily practice, guided and monitored by the Medication Adherence Knowledge and Expertise and Implementation Taskforce (Make-It).

Objectives: This study aims to evaluate the implementation outcomes and barriers and facilitators for implementation of these interventions.

Methods: Both qualitative and quantitative data were collected. Semi-structured interviews with six project leaders from four living labs were held. Documentation generated by the living lab and Make-It consortium (e.g. project reports, meeting minutes, logbooks) was screened and relevant data were extracted. The Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework was used to guide the data collection (interview topic guide), extraction and analyses.

Results: Three living labs reached the anticipated number of patients. Reach in the fourth living lab was hindered by suboptimal communication with patients about the goal of the intervention. All anticipated pharmacy staff members adopted the interventions. A champion (highly motivated project leader) accelerated the adoption, together with appropriate training for staff. Both pharmacy staff and patients saw the added value and appreciated the interventions, strengthening their contact. Fidelity was high in all living labs, whilst allowing adaptations to better align the intervention to their setting. Implementation was facilitated by interventions being compatible to daily practice, good leadership, intrinsic motivation of staff, and by starting small and using feedback loops to optimize the intervention before scaling up. In most living labs, the interventions were not sustained due to lack of pharmacy staff capacity and financing.

Conclusions: This evaluation showed that implementation of medication adherence interventions in daily practice is feasible and mostly depends on context-related factors. For successful implementation an investment is needed to create support and (intrinsically) motivate healthcare professionals. For sustainability, adequate resources and continued attention for the intervention is required.