PrescQIPP

Personalised Medication Support Service (PMSS): Technology for Better Care in Bristol, North Somerset and South Gloucestershire

Bristol, North Somerset and South Gloucestershire Integrated Care Board

Project summary

The problem of poor medication adherence is a significant and costly problem, particularly among older adults who are more likely to live with multiple long-term conditions and take multiple medicines. The consequences are poorer disease control, avoidable deterioration in health, wasted medicines, and increased burden on health and care services. The financial impact is also considerable, with additional GP appointments, ambulance call-outs, A&E attendances and hospital admissions. We found that existing support for people struggling with medicines is limited, inequitable, and support is fragmented between health and social care, leaving gaps in provision. This creates a clinical and economic case for more effective adherence support.

The Technology for Better Care (T4BC) project developed and tested a Personalised Medication Support Service (PMSS) to help people who struggle with managing their medicines. The project focus was to identify and trial pre-existing technologies that are available to support medication compliance. To assess the impact of these on the patient, care provision and wider healthcare system. The final aim being to assess potential for scalability and wider roll out with the creation of a business case.

The project had 3 phases

  • Phase 1: explore the opportunity to transform care (3 months)

  • Phase 2: develop and test solutions (6 months)

  • Phase 3: deploy and evaluate new services (12 months)

In Phase 3 we delivered a technology‑enabled, person‑centred service at scale across four delivery partners (community care provider, PCN, VCSE provider and private care provider). Project workers assessed potential participants at home, demonstrated a range of medication support technologies and matched the most suitable option with the person (and carers/family where relevant). Technologies ranged from simple audio/visual reminders and picture prompts to vibrating reminder watches, smartphone medication apps, pill dispensers and video calling. Participants were provided with ongoing support, as required, together with monthly telephone or in-person check in.

We recruited 118 participants, 87 completed the study questionnaires and assessments after a minimum of 29 days (maximum 241, mean 143 days). There was an improvement in self‑reported adherence (MARS‑5) with 82% of participants showing and improvement in adherence of at least two points (mean change -4.1). Only two participants had worse scores. Self‑reported health resource utilisation was assessed over the three months before vs. the three months prior to end‑of‑study, this was reduced across key domains.

Key findings

  • Digital technologies can improve adherence

  • Improved adherence may be associated with reduced health resource utilisation

  • Personalisation and follow up are important to ensure continued use

  • Technology enabled support should be integrated into routine services