Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative

Abstract Background Medication adherence data are an important quality indicator in cystic fibrosis (CF) care, yet real‐time objective data are not routinely available. An online application (CFHealthHub) has been designed to deliver these data to people with CF and their clinical team. Adoption of...

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Main Authors: Carla Girling, India Davids, Nikki Totton, Madelynne A. Arden, Daniel Hind, Martin J. Wildman
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Learning Health Systems
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Online Access:https://doi.org/10.1002/lrh2.10453
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author Carla Girling
India Davids
Nikki Totton
Madelynne A. Arden
Daniel Hind
Martin J. Wildman
author_facet Carla Girling
India Davids
Nikki Totton
Madelynne A. Arden
Daniel Hind
Martin J. Wildman
author_sort Carla Girling
collection DOAJ
description Abstract Background Medication adherence data are an important quality indicator in cystic fibrosis (CF) care, yet real‐time objective data are not routinely available. An online application (CFHealthHub) has been designed to deliver these data to people with CF and their clinical team. Adoption of this innovation is the focus of an National Health Service England‐funded learning health system and Quality Improvement Collaborative (QIC). This study applies the capability, opportunity, and motivation model of behavior change to assess whether the QIC had supported healthcare professionals' uptake of accessing patient adherence data. Method This was a mixed‐method study, treating each multidisciplinary team as an individual case. Click analytic data from CFHealthHub were collected between January 1, 2018, and September 22, 2019. Thirteen healthcare practitioners participated in semi‐structured interviews, before and after establishing the QIC. Qualitative data were analyzed using the behavior change model. Results The cases showed varied improvement trajectories. While two cases reported reduced barriers, one faced persistent challenges. Participation in the QIC led to enhanced confidence in the platform's utility. Reduced capability, opportunity, and motivation barriers correlated with increased uptake, demonstrating value in integrating behavior change theory into QICs. Conclusion QICs can successfully reduce barriers and enable uptake of e‐health innovations such as adherence monitoring technology. However, ongoing multi‐level strategies are needed to embed changes. Further research should explore sustainability mechanisms and their impact on patient outcomes.
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spelling doaj-art-bb2e27f480ef46e2bb21efa628bceddd2025-08-20T02:11:51ZengWileyLearning Health Systems2379-61462025-04-0192n/an/a10.1002/lrh2.10453Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborativeCarla Girling0India Davids1Nikki Totton2Madelynne A. Arden3Daniel Hind4Martin J. Wildman5Clinical Trials Research Unit University of Sheffield Sheffield UKClinical Trials Research Unit University of Sheffield Sheffield UKClinical Trials Research Unit University of Sheffield Sheffield UKDepartment of Psychology, Sociology and Politics Sheffield Hallam University Sheffield UKClinical Trials Research Unit University of Sheffield Sheffield UKSheffield Adult Cystic Fibrosis Unit Sheffield Teaching Hospitals NHS Foundation Trust Northern General Hospital Sheffield UKAbstract Background Medication adherence data are an important quality indicator in cystic fibrosis (CF) care, yet real‐time objective data are not routinely available. An online application (CFHealthHub) has been designed to deliver these data to people with CF and their clinical team. Adoption of this innovation is the focus of an National Health Service England‐funded learning health system and Quality Improvement Collaborative (QIC). This study applies the capability, opportunity, and motivation model of behavior change to assess whether the QIC had supported healthcare professionals' uptake of accessing patient adherence data. Method This was a mixed‐method study, treating each multidisciplinary team as an individual case. Click analytic data from CFHealthHub were collected between January 1, 2018, and September 22, 2019. Thirteen healthcare practitioners participated in semi‐structured interviews, before and after establishing the QIC. Qualitative data were analyzed using the behavior change model. Results The cases showed varied improvement trajectories. While two cases reported reduced barriers, one faced persistent challenges. Participation in the QIC led to enhanced confidence in the platform's utility. Reduced capability, opportunity, and motivation barriers correlated with increased uptake, demonstrating value in integrating behavior change theory into QICs. Conclusion QICs can successfully reduce barriers and enable uptake of e‐health innovations such as adherence monitoring technology. However, ongoing multi‐level strategies are needed to embed changes. Further research should explore sustainability mechanisms and their impact on patient outcomes.https://doi.org/10.1002/lrh2.10453CFHealthHubcystic fibrosise‐health innovationhealth behavior changeimplementation sciencelearning health system
spellingShingle Carla Girling
India Davids
Nikki Totton
Madelynne A. Arden
Daniel Hind
Martin J. Wildman
Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
Learning Health Systems
CFHealthHub
cystic fibrosis
e‐health innovation
health behavior change
implementation science
learning health system
title Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
title_full Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
title_fullStr Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
title_full_unstemmed Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
title_short Changing practice in cystic fibrosis: Implementing objective medication adherence data at every consultation, a learning health system and quality improvement collaborative
title_sort changing practice in cystic fibrosis implementing objective medication adherence data at every consultation a learning health system and quality improvement collaborative
topic CFHealthHub
cystic fibrosis
e‐health innovation
health behavior change
implementation science
learning health system
url https://doi.org/10.1002/lrh2.10453
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