The purpose of this feasibility study was to improve and implement an intervention aimed at enhancing medication adherence in sub-optimally controlled and non-adherent type 2 diabetes (T2DM) patients in primary care. Four phases were completed: (1) context analysis, (2) collaboration protocol development, (3) digitalization, and (4) process evaluation. Two community pharmacies and seven general practices participated. In phase 1, two focus groups were conducted, of which one with healthcare providers (HCP, N = 5) and one with patients (N = 11). In phase 4, four semi-structured interviews and one focus group (N = 6) were conducted with healthcare providers. The goal of these focus groups and interviews was to obtain insights into current care to support medication adherence (phase 1), opportunities for collaboration (phase 2) and process evaluation (phase 4). Data were analyzed in Atlas.ti using thematic analyses. Both T2DM patients and HCPs considered medication adherence vital. Suboptimal collaboration between HCPs and unreliable ways to monitor medication non-adherence appeared important barriers for adequate care to support medication adherence (phase 1). The nurse practitioner (NP) was chosen as the interventionist with supportive roles for other HCPs (phase 2). All components of the intervention were digitalized (phase 3). The implementation of the digitalized intervention was reported to be suboptimal (phase 4). Main reasons were that pharmacy refill data were unreliable, NPs experienced difficulties addressing medication non-adherence adequately and collaboration between HCPs was suboptimal. The medication adherence enhancing intervention was successfully digitalized, but implementation of the digitalized intervention appeared not feasible as of yet.

中文翻译：

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以数字化护士从业者为主导的干预措施的可行性研究，以提高荷兰初级保健中 2 型糖尿病患者的药物依从性

本可行性研究的目的是改进和实施一项干预措施，旨在提高初级保健中次优控制和非依从性 2 型糖尿病 (T2DM) 患者的药物依从性。完成了四个阶段：（1）上下文分析，（2）协作协议开发，（3）数字化，以及（4）过程评估。两家社区药房和七家全科诊所参加了。在第一阶段，进行了两个焦点小组，其中一个与医疗保健提供者（HCP，N = 5）和一个与患者（N = 11）。在第 4 阶段，与医疗保健提供者进行了四次半结构化访谈和一个焦点小组（N = 6）。这些焦点小组和访谈的目标是深入了解当前的护理以支持药物依从性（第 1 阶段），合作机会（第 2 阶段）和过程评估（第 4 阶段）。使用专题分析在 Atlas.ti 中分析数据。T2DM 患者和 HCP 都认为药物依从性至关重要。HCP 之间的次优合作和不可靠的药物不依从性监测方法似乎是提供足够护理以支持药物依从性的重要障碍（第 1 阶段）。执业护士 (NP) 被选为干预者，为其他 HCP 提供支持（第 2 阶段）。干预的所有组成部分都已数字化（第 3 阶段）。据报道，数字化干预的实施并不理想（第 4 阶段）。主要原因是药房补充数据不可靠，NP 在充分解决药物不依从性方面遇到困难，以及 HCP 之间的合作欠佳。