Managing Medications During 'Sick Days' in Patients with Diabetes, Kidney, and Cardiovascular Conditions: A Theory-Informed Approach to Intervention Design and Implementation.

OBJECTIVE(S): To (1) explore barriers and enablers to patient and healthcare providers (HCPs) behaviours related to SDMG, (2) identify theory-informed strategies to advise SDMG intervention design, and (3) obtain perspectives on an eHealth tool for this purpose.

METHODS: A qualitative descriptive study using qualitative conventional content analysis was undertaken. Interviews and focus groups were held with patients and HCPs from January 2021 to April 2022. Data was analyzed using the behaviour change wheel and theoretical domains framework to inform intervention design.

RESULTS: Forty-eight people (20 patients, 13 pharmacists, 12 family physicians, and 3 nurse practitioners) participated. Three interventions were designed to address the identified barriers and enablers: (1) prescriptions provided by a community-based care provider, (2) pharmacists adding a label to at-risk medications, and (3) built-in prompts for prescribing and dispensing software. Most participants accepted the concept of an eHealth tool and identified pharmacists as the ideal point-of-care provider. Challenges for an eHealth tool were raised included credibility, privacy of data, medical liability, clinician remuneration and workload impact, and equitable access it.

CONCLUSION: Patients and HCPs endorsed non-technology and eHealth innovations as strategies to aid in the delivery of SDMG. These findings can guide the design of future theory-informed SDMG interventions.