In our latest interview we spoke with Gayle Campbell, a senior cardiovascular pharmacist at Guy’s and St Thomas’ NHS Foundation Trust, who has developed MedTap – a new medications app to support patients take their medications correctly.
MedTap, features videos with NHS clinicians providing similar information to what patients would hear in their consultations. This helps to prompt patients about medications, strengthening their understanding on how and when to take them appropriately. Videos are available for medicines post a heart attack and for direct action oral anticoagulants in atrial fibrillation providing answers to common medication questions such as when and how to take pills, what to do about side effects, how to re-order more pills and the cost. Users can record their medicines, appointments and test results to help improve self-management of their care.
Could you tell me a bit about yourself?
I am a cardiovascular pharmacist at Guys and St Thomas’ specialising in heart failure. As part of my role, I work across primary and secondary care, trying to ensure medicines optimisation and promote better adherence to medication.
When did you first think of the idea to develop MedTap?
Non-adherence is well documented nationally, and patients not taking their medications as intended can cause deterioration in their symptoms and possibly even hospital admission. In the UK, we find that almost a third of patients are already not taking their medicines correctly just 10 days after starting a medicine.
My interest in adherence started as a result of my practice as a pharmacist. I would counsel patients in hospital, yet found that on a subsequent visit, those same patients would ask questions that I knew we had previously discussed. It shouldn’t be surprising, though. Many patients can feel overwhelmed when in hospital or clinic, both by the experience and the amount of information they receive. Literature has shown that most of that information isn’t retained.
In 2013, the cardiovascular pharmacy team did a research project looking at patient satisfaction on medicine information provided. It demonstrated that patients were more likely to be non-adherent if they were not satisfied with the information received. As part of the study a leaflet was introduced, encouraging patients to ask questions. This simple intervention improved patient satisfaction on the medicine information provided. It was this research that helped to pave the way for MedTap becoming a reality.
The development of digital technologies, has changed the way people access their information and together with a drive towards paperless working, to me the logical next step was to develop a digital platform for patients to access medicine information.
Whilst there is a lot of information available online, patients often have to read through large quantities of text or watch long videos before they find the information they require, and the ability to extract information in this fashion is a skill. We wanted to create a platform where patients could access the information they needed quickly and concisely. The concept of the videos is that they are all short (around two minutes), and patients only need to watch the one they require.
How did the project to develop the app start?
In 2016 the Cardiovascular Research Fund at Guy’s and St Thomas’ had a Dragons’ Den style competition. They actively encouraged non-medical specialities to enter. Therefore the senior cardiovascular pharmacy team pitched for funding for a proof of concept study to create a series of short videos and to evaluate to see if patients found these useful. We were successful in our pitch and all of the “dragons” unanimously backed us to deliver the videos.
At that time direct acting oral anticoagulants were becoming ever more popular in cardiology. We had recently completed a satisfaction survey showing that patients who started on these medicines were less satisfied with the information provided than those starting on warfarin. So, we decided to start there and focussed on the direct acting oral anticoagulants in atrial fibrillation.
The videos launched in 2017 through the trust YouTube channel. They are all scripted and checked by pharmacists, consultants, and the patient information team. Analysis showed that patients were more satisfied after watching the videos in conjunction with standard counselling as compared to counselling alone. The next logical step was to take this forward and develop an app, where patients could easily access all of the information in one place on a device they likely have with them at all times.
In 2018 we won an anticoagulation achievement award for the videos, which resulted in further funding by the Cardiovascular Research Fund. We used this funding to create MedTap, which is free to download as of August 2019.
Could another trust adopt and use the app?
Absolutely anyone can use it. We are looking to expand MedTap to add more conditions, with a number of dermatology videos being currently added. We plan to launch a heart failure module in 2020. We also in the process of developing a medicine reminder function.
We have applied for funding to evaluate the app formally. This will allow us to understand how MedTap is changing underlining health beliefs, increasing patient satisfaction and, most importantly, improving adherence.
We have had around 800 downloads to date and we plan to continue to promote the app, to ensure that many more patients can benefit from its use.
What have you learned through this process?
It’s not easy to take a project like this from a concept to reality. You really have to believe in your project and be passionate about it. Funding is difficult to obtain (and rightly so) in the NHS.
Networking and ongoing promotion have increased MedTap’s visibility, and this in turn, has led to greater awareness, and hopefully additional topics to help even more patients in future…