Medicines management within primary care; patient medication taking behaviour; pharmacist service development; pill organisers; medication adherence support decision aid; pharmacy; medication; HIV medication

Video: Dr Debi Bhattacharya: Medication Adherence Support Decision Aid

I am Professor of Behavioural Medicine at the University of Leicester and a primary care pharmacist. I lead a portfolio of research applying behavioural science to medicine-related challenges. I am experienced in delivering research spanning the full spectrum from diagnosing the nature of the problem through to designing targeted interventions and large-scale testing in definitive trials. My work includes both patient and practitioner behaviour change; two key strands are supporting deprescribing and medication adherence. Current research programmes that I am leading on these topics include:

• CHARMER which is a five year, £2.4M NIHR funded research programme to design and test a deprescribing intervention across 24 hospitals in England.
• IMAB-Qi which is a five year, £2.7M NIHR funded research programme to design and test a medication adherence intervention across 38 medical practices in England.

I am also passionate about research capacity building to secure the future of evidence-based healthcare. I am currently leading the NIHR incubator for pharmacy professionals which is three years of funding to build research capacity amongst the pharmacy profession.

My national/international roles include membership of the funding panels for NIHR Programme Grants for Applied Research and NIHR pre-application support fund, Pharmacy Research Advisory group and editorial boards for the journals Patient Preference and Adherence and International Journal of Pharmacy practice.

Below are links to some projects that form the core of my recent research:

• Medication Adherence Support Decision Aid (MASDA)
• Identification of Medication Adherence Barriers Questionnaire (IMAB-Q)
• Opioid deprescribing toolkit
• Medication Acceptability Questionnaire (MAQ)

Steven Watson (with Malcolm Adams) – Use of psychometrics to develop a self reported adherence questionnaire.

I joined the University of East Anglia in 2010 to complete a PhD entitled 'Development of a novel, validated tool for predicting patient adherence to prescribed medication'. As well as a particular interest in medication taking behaviour I have a more general interest in the roles of evolution, emotions, and somatic experience upon decision making. I am also interested in research synthesis and meta-analysis.

Before joining the UEA I gained my Psychology BSc (Hons) from Newcastle University in 2006. I then attained the degree of Master of Research in Psychology from Northumbria University in 2009, with a thesis entitled “The ‘halo effect’ as an evolved mechanism to promote short term mating with attractive partners”. Whilst at Northumbria I also conducted research into the effects of pre-natal androgen exposure on sexual dimorphism and aggression via differences in digit ratios.

Publications:
D. Bhattacharya, C. Easthall, S. Watson, M. Small. Capecitabine non-adherence: exploration of magnitude, nature and contributing factors. Journal of Oncology Pharmacy Practice. (In press)

J. Hönekopp, S. Watson (2011) Meta-analysis of the relationship between digit-ratio 2D:4D and aggression. Personality and Individual Differences. 51 (4): 381-386.

J. Hönekopp, S. Watson (2010) Meta-analysis of digit ratio 2D:4D shows greater sex difference in the right hand. American Journal of Human Biology. 22 (5): 619-630.

Conference Abstracts
S. Watson, D. Bhattacharya, J. Wood, J. Smith, M. Adams, F. Song (2011) Systematic review and meta-analysis shows stress is negatively associated with adherence to medication. International Journal of Pharmacy Practice. 19 (s1): 49-50.

Michael Twigg (with David Wright, James Desborough) - Development of community pharmacy services to support patient adherence to prescribed therapy with a particular focus on eczema and diabetes

Claire Easthall (with David Wright) – Development of community pharmacy services including domiciliary care to support patient adherence to prescribed therapy

I joined the Medicines Management Research Group as a PhD student in October 2010, having qualified as a pharmacist in July of the same year.  I now continue to work as a locum community pharmacist whilst working on my PhD which is centred around the complex phenomenon of medication taking behaviours.  My current research aims to explore and enhance patient medication behaviours by focusing on different aspects of non-adherent behaviour.   Whilst a service evaluation of a domiciliary medicines support service will investigate interventions targeting unintentional non-adherence, a greater focus will be made upon the area of intentional non-adherence, where patients choose not to take their medication as prescribed.  I am particularly interested in exploring and developing the use of cognitive based behavioural interventions as a means to altering patient behaviour and enhancing medication adherence and a large proportion of my PhD will centre around this.  My research interests also lie with the evolving role of community pharmacists and the contribution to healthcare that can be made through their effective utilisation.

Prior to joining the Medicines Management Research Group,  I had experience working in community pharmacy, initially as a pharmacy assistant and progressing to pre-registration pharmacist upon completion of my undergraduate masters degree in pharmacy, here at the UEA’s School of Pharmacy.  I also have experience of working as a dispenser and medical receptionist in a GP’s surgery, where my passion for pharmacy and interest in medication adherence were first ignited.

Publications:
D. Bhattacharya, C. Easthall, S. Watson, M. Small. (2012). 
Capecitabine non-adherence: exploration of magnitude, nature and contributing factors. Journal of Oncology Pharmacy Practice. 0 (0): 1-10.

Easthall C, Song F, Bhattacharya D. (2013).  
A meta-analysis of cognitive-based behaviour change techniques as interventions to improve medication adherence. BMJ Open, 3:e002749 DOI:10.1136/bmjopen-2013-002749 

Conference Abstracts
Easthall C, Watson S, Wright D, Wood J, Bhattacharya D (2012). The impact of motivational interviewing (MI) as an intervention to improve medication adherence; a meta-analysis. 
The International Journal of Pharmacy Practice. (In press)

Easthall C, Wright D, Taylor N, Bhattacharya D (2012). Developing the ‘Identification of Medication Adherence Barriers (IMAB) instrument: A novel application of behaviour change theoretical frameworks.
Presented at the UK Society of Behavioural Medicine (UKSBM) 8th Annual Scientific Meeting, Manchester, Dec. 2012

Dr Estelle Payerne: Research Associate

I joined the medicines management research team in September 2011 as a Research Associate to develop an expertise in systematic reviews and meta analyses. I am currently working with colleagues on systematic reviews and meta analyses related to the predictors of medication adherence and effect of cognitive based techniques on medication adherence.

Prior to this I was already working in the school of Pharmacy but as a Senior Research Associate in Medicinal Chemistry. I was part of Prof M. Searcey’s group and was involved in several research projects focussing in the synthesis of peptides and small organic molecules with potential anti inflammatory and anti carcinogenic activities. I also undertook my PhD within the medicinal chemistry group working for Dr S. Matthews and my project was looking at the use of calix[4]arenes as scaffolds for new drug delivery systems.

Heidi Cate, PhD student (with Allan Clarke) – Developing and evaluating adherence interventions for patients with glaucoma.

I started my PhD with the Medicines Management Team (within the School of Pharmacy) in July 2011. My work centres around best practice and management of patients suffering with glaucoma. I have an interest in ways in which to improve patient adherence to medication, particularly with glaucoma patients. Before starting my PhD I was a Research Co-ordinator for the Glaucoma Research Unit at Norfolk & Norwich University Hospital Eye Department, carrying out clinical and surgical trials. I continue to manage the research team, during my period of study at the UEA. 

Eman Hammad (with David Wright, John Wood) – An evaluation of the quality of information transfer between secondary and primary care and the extent of medicines reconciliation in primary care

Rowan Yemm (with David Wright, John Wood) – Estimation of the relative importance of information transferred at hospital discharge and evaluation of an electronic hospital discharge system.

Clare Aldus
I joined the School of Pharmacy in January 2012 as a Senior Research Associate to manage a Health Technology Assessment project to assess the effectiveness and cost effectiveness of multi-compartment medication devices. The project encompasses systematic review, focus groups, electronic medication event monitoring technology and a pilot study to test the effect of multi-compartment medication devices and requires close collaboration between researchers, students, health professionals and the public. I previously worked as a researcher at the Institute of Food Research (IFR), Norwich in the area of food safety microbiology with major focus on highly dangerous pathogens including Clostridium botulinum and verotoxigenic Escherichia coli. In addition to this I carried out work to support the mathematical modelling team in development of dynamic microbiological modelling programs and databases and have worked in collaboration with UEA on a Health Technology Assessment systematic review project. My main interest is the development and validation of methods and in addition to my work at IFR I was also a member of British and International Standards Organisation committees for the Microbiological Safety of Food and Animal Feed, carrying out work to develop and validate either traditional or molecular International Standard Methods for E. coli O157, Campylobacter jejuni and C. botulinum. 

Research papers
Peck M. W., Plowman J., Aldus C. F., Wyatt G. M., Penaloza Izurieta W., Stringer S. C., Barker G. C.
Development and application of a new method for specific and sensitive enumeration of spores of nonproteolytic Clostridium botulinum types B, E and F in foods and food materials.
Applied and Environmental Microbiology, 2010, 76 6607-6614.

De Medici D., Anniballi F., Wyatt G. M., Lindstrom M., Messelhauser U., Aldus C. F., Delibato E., Korkeala H., Peck M. W., Fenicia L.
Multiplex PCR to detect botulinum neurotoxin-producing clostridia in clinical, food and environmental samples.
Applied and Environmental Microbiology, 2009, 75 6457-6461.

Le Marc Y., Plowman J., Aldus C. F., Munoz-Cuevasa M., Baranyi J., Peck M. W.
Modelling the growth of Clostridium perfringens during the cooling of bulked meat.
International Journal of Food Microbiology, 2008, 128 41-50.

Abubakar I., Irvine L. , Aldus C. F. , Wyatt G. M. , Fordham R. , Schelenz S. , Shepstone L. , Howe A. , Peck M. W. , Hunter P. R.
A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of intestinal pathogens in faeces, food and water.
Health Technology Assessment, 2007, 11 1-195.

Capps K. L., McLaughlin E. M., Murray A. W. A., Aldus C. F., Wyatt G. M., Peck M. W., van Amerongen A., Wichers J. H., Baylis C. L., Wareing D. R. A., Bolton F. J.
Validation of three rapid screening methods for detection of verotoxin-producing Escherichia coli in foods.
Interlaboratory study Journal of AOAC. International, 2004, 87 68-77.

Aldus C. F., Ariens R. M.C., Wichers J. H., Peck M. W., van Amerongen A., Wyatt G. M.
Principles of some novel rapid dipstick methods for detection and characterization of verotoxigenic Escherichia coli
Journal of Applied Microbiology, 2003, 95 380-389. 

Trish Boyton - I joined the Medicines Management Research Group as a Research Associate in January 2012, working with colleagues on a pilot study of the effectiveness of Multi Compartment medicine devices. My background is in nursing, much of which was in the community. At present I am studying for a Masters in Psychological Research Methods.  

Sathon Boonyaprapa - I joined the medicines management research team in August 2011 as a Senior Research Associate. I am currently working for Dr D. Bhattacharya within the Medicine Organisers Project-A pilot study of the effectiveness and cost effectiveness of Multi Compartment medication devices. My personal interest is in the research related to health behaviour, pharmacy practices, medicine management, and evaluation of healthcare projects. Before joining the UEA, I completed my PhD in the Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham in October 2010. I gained valuable experience in both quantitative and qualitative research. While I was a PhD student, I had experience working as a part-time dispenser at Boots the Chemists. After four years in community pharmacy, I qualified as a UK pharmacy technician in May 2011. I now continue to work as a Sunday pharmacy technician at Boots the Chemists. Prior to residing in the UK, I gained my Pharmacy degree from Chiangmai University, Thailand, and I am a registered in Thailand since April 1996. I then attained a Masters degree in Pharmacy (Pharmacy administration) from Mahidol University, Thailand in 1998. My work experience in Thailand included seven years working as a lecturer in Social Pharmacy and Pharmacy Practice, Department of Pharmaceutical Care, Faculty of Pharmacy, Chiangmai University, Thailand. I also worked as a part-time pharmacist in community pharmacies and hospitals.

Research Funding

Co-applicant