Brief community pharmacy-based COPD screening & GP referral is feasible & can identify & increase COPD diagnosis.

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Smart reminders improve medication adherence through habit formation, routine and experiential learning

We know that inhaler reminders can improve treatment adherence but how?

Our new research shows that people with asthma who received inhaler reminders for missed doses plus visual feedback of their daily medication use for six months improved their adherence attitudes and behaviours through habit formation, routine and experiential learning. These changes resulted in increased confidence in asthma self-management and asthma control. Specifically, participants described a shift in their adherence attitudes because it helped them create a clearer link between poor adherence and poor asthma control.

Read the full paper at:

Reminders were considered less useful and were more often switched off by participants who disliked routine, had an existing medication-taking routine, or who preferred to take their preventer only in symptomatic periods. Change in adherence attitudes and behaviours often did not occur in these participants, nor in some who doubted the seriousness of their asthma or the necessity or safety of their preventer treatment. In clinical settings such patients may need a different level of engagement with their GPs prior to initiating, or in conjunction with adherence reminders.

Our findings fit well with the social cognitive and health belief models of health
behaviour, which have been shown to be effective for designing interventions to improve adherence. For example, our participants reported changes in their outcome expectancies (e.g. Taking my preventer will improve my asthma), self-efficacy (I can control my asthma myself), acquisition of behavioural skills (I have been trained now), and behavioural intention (I want to take my preventer to stay well). But many who had negative evaluations of the risk of taking medications or who thought they had low need for medication or low disease risk did not change adherence attitudes or behaviours. Interestingly, when the reminders were turned back on after a decline in asthma control, the personal experience of better asthma control reinforced positive adherence beliefs. Further, the greater awareness of asthma at home appeared to have encouraged collaboration with family or friends around adherence
strategies. The impact of reminders on family members could be a fruitful avenue for future research.

This research, in patients with moderate to severe asthma, is the first to explore the mechanism of behaviour change with six months use of adherence reminders and feedback and raises some interesting new questions about the use of reminder interventions:
What is the impact of different types of health professional support on reminder
outcomes (e.g. from reviewing adherence data to discussing patients’ treatment concerns or uncertainties)?
How acceptable is the sharing of adherence data between clinicians and patients?
What is the impact of medication reminders on participants’ family and friends?
What is the duration of behavioural benefit gained from inhaler reminders?
What is most effective length of reminder interventions?
What is the best format for displaying adherence data to patients?

Read the full paper at: