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Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

Two-way Automated Text Messaging Support From Community Pharmacies for Medication Taking in Multiple Long-term Conditions: Human-Centered Design With Nominal Group Technique Development Study

Donovan, Gemma, Hall, Nicola, Smith, Felicity, Ling, Jonathan and Wilkes, Scott (2022) Two-way Automated Text Messaging Support From Community Pharmacies for Medication Taking in Multiple Long-term Conditions: Human-Centered Design With Nominal Group Technique Development Study. JMIR Formative Research, 6 (12). pp. 1-19. ISSN 2561-326X

Item Type: Article


Reviews of digital communication technologies suggest that they can be effective in supporting medication use; however, their use alongside nondigital components is unclear. We also explored the delivery of a digital communication intervention in a relatively novel setting of community pharmacies and how such an intervention might be delivered to patients with multiple long-term conditions. This meant that despite the large number of intervention examples available in the literature, design questions remained, which we wanted to explore with key stakeholders. Examples of how to involve stakeholders in the design of complex health care interventions are lacking; however, human-centered design (HCD) has been suggested as a potential approach.

This study aimed to design a new community pharmacy text messaging intervention to support medication use for multiple long-term conditions, with patient and health care professional stakeholders in primary care.

HCD was used to map the intervention “journey” and identify design questions to explore with patients and health care professionals. Six prototypes were developed to communicate the intervention concept, and a modified version of the Nominal Group Technique was used to gather feedback. Nominal group meetings generated qualitative data using questions about the aspects that participants liked for each prototype and any suggested changes. The discussion was analyzed using a framework approach to transform feedback into statements. These statements were then ranked using a web-based questionnaire to establish a consensus about what elements of the design were valued by stakeholders and what changes to the design were most important.

A total of 30 participants provided feedback on the intervention design concept over 5 nominal group meetings (21 health care professionals and 9 patients) with a 57% (17/30) response rate to the ranking questionnaire. Furthermore, 51 proposed changes in the intervention were generated from the framework analysis. Of these 51 changes, 27 (53%) were incorporated into the next design stage, focusing on changes that were ranked highest. These included suggestions for how text message content might be tailored, patient information materials, and the structure for pharmacist consultation. All aspects that the participants liked were retained in the future design and provided evidence that the proposed intervention concept had good acceptability.

HCD incorporating the Nominal Group Technique is an appropriate and successful approach for obtaining feedback from key stakeholders as part of an iterative design process. This was particularly helpful for our intervention, which combined digital and nondigital components for delivery in the novel setting of a community pharmacy. This approach enabled the collection and prioritization of useful multi-perspective feedback to inform further development and testing of our intervention. This model has the potential to minimize research waste by gathering feedback early in the complex intervention design process.

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Depositing User: Nicola Hall


Item ID: 15700
Identification Number:
ISSN: 2561-326X
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Users with ORCIDS

ORCID for Nicola Hall: ORCID iD
ORCID for Jonathan Ling: ORCID iD
ORCID for Scott Wilkes: ORCID iD

Catalogue record

Date Deposited: 20 Feb 2023 14:09
Last Modified: 20 Feb 2023 14:09


Author: Nicola Hall ORCID iD
Author: Jonathan Ling ORCID iD
Author: Scott Wilkes ORCID iD
Author: Gemma Donovan
Author: Felicity Smith

University Divisions



Sciences > Health Sciences
Sciences > Pharmacy and Pharmacology

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