ESPACOMP PRE CONFERENCE WORKSHOP: Version

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1 ESPACOMP PRE CONFERENCE WORKSHOP: Version Budapest, Hungary, 14 November 2013, "Gobelin" room. Medication Adherence interventions: translating the state of art evidence in to your daily clinical practice Moderators:, PhD, RN (University of Basel, Switzerland & KU Leuven, Belgium) Martha Hill, PhD, RN (Johns Hopkins University, Baltimore, USA) Faculty: Duration: Hayden Bosworth, PhD, Duke University (USA),, PhD, RN (University of Basel, Switzerland & KU Leuven, Belgium), Martha Hill, PhD, RN (Johns Hopkins University, Baltimore, USA, Marie Schneider, PhD, RPh, University of Lausanne & Geneva (CH), Liset Van Dijk, PhD, NIVEL (NL). 6 hours Introduction: Medication non adherence is a major public health problem negatively impacting clinical and economical outcomes. The state of science in view of adherence interventions is steadily growing I view of randomized clinical trials, systematic literature reviews and meta analyses. Whereas most tested adherence interventions have targeted the patient level, it is recognized in order to effectively tackle medication non adherence, that multi level interventions are needed. Multi level interventions refer to targeting not only patients yet also health care workers (micro level) (e.g. communication style; competencies for behavioral change management), the organization of care processes (meso level) (e.g. continuity of care; continuous behavioral assessments integrated as part of follow up) and/or health care system (e.g. medication coverage). Health care technology is increasingly used as part of adherence enhancing interventions (e.g. electronic monitoring feedback, reminder systems). Translating the state of evidence regarding adherence enhancing interventions into daily clinical practice remains nevertheless a major challenge. This workshop has following goals: To discuss multi level medication adherence interventions. To present case studies of adherence interventions implemented in daily clinical practice with or without the use of health care technology. To reflect and discuss the use and implementation of medication adherence interventions in your daily clinical practice. Learning methods: presentations, case studies, group work, discussion round Bibliography: will be send to the participants the beginning of November. All participants need to print out the materials themselves as no hard copies will be provided at the conference!!

2 PROGRAM Welcome and review of workshop program Each of faculty presents him/herself. Participants are invited to communicate his/her expectations/goals for the workshop Multi level medication adherence interventions: State of science Goal: to explain multilevel perspective and exemplify each level with evidence How to communicate clearly what we are doing in research and practice? Use of behavioral taxonomies for adherence enhancing interventions. Goal: to introduce Michie et al. s Behavioral Change Technique Taxonomy V1 to describe and communicate components of interventions and to showcase the link with behavioural theory (Michie et al. Ann. Beh. Med., 2013) Group work: Discussion of perceived/experienced valuable intervention(s), barriers and facilitators in the implementation and sustainability of adherence interventions in the daily clinical practice. Each table receives a chart with different levels to note interventions, barriers & facilitators. Findings are synthesized during break, printed out and distributed to participants for further group work Coffee Break Translation of medication adherence intervention in practice: from efficacy to effectiveness Goal: to discuss criteria to identify potential successful research projects to be scaled up into implementation. To highlight methods to scale and evaluate the implementation of medication adherence programs Case studies per case study Goal of the case studies is to provide examples from real life. The presenters will: highlight at which level(s) the adherence intervention(s) was/were implemented use the Michie et al. s Behavioral Change Technique Taxonomy V1 to describe the content of the intervention(s). make links with behaviorai theory where relevant. highlight use of health care technology yet also position this using Michie et al. s Behavioral Change Technique Taxonomy V1. describe barriers and used strategies for implementation and/or sustainability of the intervention. report outcomes if they are available. 1. Implementation of real time medication monitoring in Dutch community pharmacies: a challenge 2. A pharmacist led adherence clinic as part of the outpatient department of the University Hospital of Lausanne 3. Medicaid adherence program for hypertension. & Martha Hill Martha Hill All participants 5 groups: max 10 persons per group (a faculty member will be part of each group) Hayden Bosworth Liset van Dijk Marie Schneider Hayden Bosworth

3 Break Group work: Discussion of findings of 1 st group work in light of the presented theory and case studies (synthesis notes 1 st group work will be provided to all groups) What are strategies / interventions which you deem to be valuable for your practice setting/patient population? How do you plan to tackle the issues you anticipate to encounter in your practice setting for implementing these strategies? What do you see as first step to be successful in the implementation of change in your context? Discussion round: group work The groups report back the content of their discussion Faculty and other participants participate actively in the discussion Identifying common themes and strategies Evaluation of workshop & conclusion Review of the goals of the workshop What was appreciated? What was less valuable? Which content has not been covered that could be integrated in a similar workshop at the next year s ESPACOMP conference in Lausanne (CH)? What should be the emphasis / priorities for research from your perspective? All participants 5 groups: max 8 10 persons per group moderated by faculty member Each group has a reporter for the group discussion Martha Hill Marie Schneider Liset van Dijk Hayden Bosworth Martha Hill &

Faculty Biosketches Martha Hill, PhD, RN Professor, Nursing, Medicinee & Public Health The Johns Hopkins University Dean, School of

underserved African Americans, particularly young men.

Disparities in Health Care." " In 1997 98, she was the first non physician to serve as president of thee American Heart Association.

Bosworth, PhD Professor in Medicine, Psychiatry and Behavioral Sciences Department Medicine / Division General Internal Medicine Duke

4 Faculty Biosketches Martha Hill, PhD, RN Professor, Nursing, Medicinee & Public Health The Johns Hopkins University Dean, School of Nursing 525 N. Wolfe St. Baltimore, Md Phone: (410) E mail: Web page: Martha Hill, a Johns Hopkins faculty memberr since 1980, became dean of the Johns Hopkins University School of Nursing in July 2002 after a year as interim dean. Hill is internationally known forr developing and testing strategies too improve hypertension care c and control among urban, underserved African Americans, particularly young men. She is a fellow of the American Academy of Nursing and a member of the Institutee of Medicinee (IOM) of the National Academy of Sciences. She was co vice chair of the IOM committee thatt developed a report titled "Unequal Treatment: Confronting Ethnic and Racial Disparities in Health Care." " In , she was the first non physician to serve as president of thee American Heart Association. Hayden B. Bosworth, PhD Professor in Medicine, Psychiatry and Behavioral Sciences Department Medicine / Division General Internal Medicine Duke University /medicine.duke.edu/faculty/details/ Dr. Bosworth, a health services researcher, r focuses on patient and organization level factors to improve chronic care outcomes using telemedicine and mobile health platforms.. His research interestss comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients treatment adherencee and self management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate healthh care disparities. He is currently the PI on four self management interventionss and Co PI on three other funded studies. He is the recipient of an American Heart Associationn establishedd investigatorr award,

the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientistt

Bosworth has expertise developing interventions to improve health behaviors has been developing and implementing tailored patient intervention s to reduce the burden of other chronic diseases.

5 the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientistt Award. In terms of self management, related to hypertension, coronary arteryy disease, and depression, and Dr. Bosworth has expertise developing interventions to improve health behaviors has been developing and implementing tailored patient intervention s to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use memberss of the healthcare team,, particularlyy pharmacists and nurses. He has been the Principal Investigator of over 10 trials resulting in over 220 peer reviewed publications and four books. Thiss work has been or is being implemented in multiple arenas including i Medicaidd of North Carolina, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs. He will talkk about the transition from efficacy/effectiveness, to implementation of medication adherence programs. Liset van Dijk, PhD Nederlands instituut voor onderzoek van de gezondheidszorg / van dijk Liset van Dijk, PhD (1965) wass trained as a sociologist at Wageningen University and Utrecht University. From 1999 onwards Liset is employed at NIVEL, Netherlands institute for healthh services research in Utrecht, where she is research coordinator of pharmaceutical care. In 2007, she joined the Division of Pharmacoepidemiology and Clinical Pharmacy at Utrecht University as adjunct faculty. Her main research interests include adherence to medication, drug utilisation research, international comparisons, and policy evaluation. She is/ /was the copromotor of ten PhD thesis half of which focuss on medication adherence. Liset wass the project t leader of the website that monitors adherence in the Netherlands ( She is a member of the Dutch task force on adherence improvement ( ; 2013) and the initiator of the Netherlands Scientific Group on Adherence (started in 2012).

Dr. Marie Schneider Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne Marie Paule.

She graduated from the University of Lausanne, Switzerland, and obtained her PhD thesis in 2003.

Since 2004, she manages a drug adherence clinicc at the Pharmacy of the Department of Ambulatory Care and Community Medicine in Lausanne.

She teaches at the Chair in Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, Universityy of Lausanne, especially in

She developed and implemented a quality management system for clinical research in community care at the Department of Ambulatory Care and

She is a board member of the Europeann Society for Patient Adherence, Compliance and Persistence (ESPACOMP) and a member of the Motivational

ch/institute/associates/profil/pers on/degeest/ is a Professor off Nursing andd Director of the Institute of Nursing g Science of the t Faculty

6 Dr. Marie Schneider Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne Marie Marie Schneider is a pharmacist. She graduated from the University of Lausanne, Switzerland, and obtained her PhD thesis in Her research focuses on the long term management of medication adherence in chronic patients. Since 2004, she manages a drug adherence clinicc at the Pharmacy of the Department of Ambulatory Care and Community Medicine in Lausanne. Thee adherence clinic has developed a close collaboration with physicians, who refer their chronic patients experiencing adherence problems. She teaches at the Chair in Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, Universityy of Lausanne, especially in the areas of medication adherence and motivational interviewing. She developed and implemented a quality management system for clinical research in community care at the Department of Ambulatory Care and Community Medicine in Lausanne. She is a board member of the Europeann Society for Patient Adherence, Compliance and Persistence (ESPACOMP) and a member of the Motivational Interviewing Network of Trainerss (MINT). Sabinaa De Geest, Ph.D., R.N.. Professor of Nursing University of Basel, Switzerland KU Leuven Belgium sabina.degeest@unibas.ch /nursing.unibas.ch/institute/associates/profil/pers on/degeest/ is a Professor off Nursing andd Director of the Institute of Nursing g Science of the t Faculty of Medicine at the University of Basel, Switzerland. She is alsoo a part timee Professor of Nursing at the Center for Health Services andd Nursing Research at the KU Leuvenn (Belgium) and adjunct Professor at the Johns Hopkins University (USA). leads the Leuven Basel Adherence Research Group, an a international, interdisciplinary research group focusing on behavioural and psychosocial issues, withh the ultimate goal of improving clinical outcomes in chronically ill patient populations (e.g., solid organ & stem cell transplantation). Projects currently conducted in Europe Australia and North & South America focus on the prevalence, determinants and consequencess (both clinical and economic) of non adherence to medication regimens, and on testing the efficacy of adherence enhancing interventions.

18 th ANNUAL ESPACOMP MEETING (November 20-22, 2014 in Lausanne, Switzerland)

18 th ANNUAL ESPACOMP MEETING (November 20-22, 2014 in Lausanne, Switzerland) THURSDAY NOVEMBER 20 (pre-conference educational day) 09:00-09:30 Registration and welcome 09:30-17:00 Parallel sessions Workshop