ARC Themes
Resource Stage
Status
Health Category
Why the research is needed
Most patients who have heart disease or are at risk for developing heart disease in the future should be receiving drugs, known as statins, to reduce the amount of unhealthy cholesterol (fat) in their blood. A large number of patients are not receiving or taking these drugs in the way that they should be. This means they are at a greater health risk. This has been investigated through the Med Help (MH) study. This follow-on study aims to use focus groups or in-depth interviews to explore barriers, enablers and the experiences of patients who have been involved in the MH study. A second series of focus groups, or in-depth interviews will also be undertaken to investigate if this can be rolled-out to a wider group.
What is already known about the subject
Doctors often do not prescribe the right amount of statins because they incorrectly think that they are not necessary or may cause unwanted side effects. This puts patients at risk, and previous efforts to educate healthcare staff have had some success in improving statin prescription. Patients may also not take statins regularly when they are prescribed them. Previous research has shown that text message reminders for medications statin may help patients to take them more regularly. However, no research so far has tried to both educate doctors and provide patients with informational reminders in a simple and low-cost way to increase overall statin use.
Who we will be working with
The MH study worked with local GP practices for the delivery of the intervention, a digital software company (PRIMIS) to design and deliver the text intervention, and educational specialists within the Leicester Diabetes Centre to design the educational sessions for participating clinicians.
This follow-on study will work first with patients to explore enablers and barriers to statin adherence within the context of the MH intervention. A second series of focus groups or in- depth interviews* will then be undertaken to explore the acceptability and implementation of the MH study. This will include researchers involved in the MH study, clinicians/practice managers involved in the delivery of MH and commissioners/Primary Care Network Leads responsible for the development and implementation of clinical services.
*In-depth interviews will be undertaken until saturation (we have captured all views), if focus- groups cannot be arranged due to participant availability.
How patients and the public are involved
The Leicester Diabetes Centre has a well-established patient and public involvement panel. We have involved patients in the design and content of our research project to ensure that our aims and outcomes match patients’ needs and expectations.
What we will do
We will undertake a series of focus groups or in-depth interviews to investigate the patient perspective, and either focus groups or in-depth interviews to investigate the stakeholder perspectives of the MH study.
What the benefits will be
This study, alongside the MH study aims to investigate a text-based system to improve statin adherence in primary care. It is hoped this will improve statin adherence and in-turn will lead to reduced cardiovascular risk. This will have wider-ranging benefits, reducing burden on clinical services through reducing medicine miss-management, and through the burden associated with cardiovascular events.
Clinical benefits
The MH study has a key potential benefit in improving statin adherence, and thereby reducing cardiovascular events. A reduction in cardiovascular events also have a wide-range of benefits, reducing morbidity and mortality for people living with cardiovascular disease. This study builds on the MH study, and looks to improve the MH intervention through insight from patients, and stakeholders. This will improve the MH intervention, and allow the roll-out of the intervention to a wider group thereby further improving statin adherence.
Benefits to clinical services
Cardiovascular disease remains a huge burden to clinical services. The low statin adherence is a further significant burden requiring further input from clinicians, and the associated waste of out-of-date or unused medication. Together, this makes CVD and statin non-adherence a burden both financially, and in clinician-hours. The MH follow-on study is aimed to explore enablers and barriers to the implementation and scale-up up of the MH study. This will bring together stakeholders to overcome identified barriers, to allow for a smoother implementation of the MH study. This will in-turn improve statin adherence, and reduce medication waste, and clinician burden.
When the findings will be available
The results of the MH intervention study are predicted in Dec 2024. The results of the follow-on study will be available in Feb 2026.
How we are planning for implementation
If the Med Help intervention is found to successfully improve statin adherence, this study will work to investigate facilitators and barriers to the further implementation and scale-up of the Med Help intervention in to a large program grant. If the Med Help intervention study is found not to improve statin adherence, this study will work to investigate facilitators and barriers and work to further refine and improve the Med Help intervention to investigate if this may be beneficial in the future.
Contact
Dr Arron Peace, Research Associate, University of Leicester, Atp11@leicester.ac.uk.