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    The International Society for Aerosols in Medicine

    Martin Wildman

    Martin Wildman

    Martin Wildman

    Sheffield University/Adult Cystic Fibrosis Centre
    United Kingdom

    Martin Wildman is an Adult pulmonologist specializing in Cystic Fibrosis. He was trained in Public Health and Health Services Research at the London School of Hygiene and Tropical Medicine. He has an interest in improvement science, system change and behavior change with an emphasis on habit formation. He leads the 19 center CFHealthHub randomized controlled trial and 3 center improvement collaborative.


    CFHealthHub: a digital platform integrating real time data capture with behaviour change to create habits of sustained adherence

    Abstract

    Background
    Cystic Fibrosis is an inherited life limiting disease in which respiratory failure due to infections is the commonest reason for death. Inhaled therapy is effective in preserving lung function and prolonging survival however median adherence to inhaled therapies is 36% or less. We describe the development of a digital platform linking adherence data to behaviour change strategies to create habits of sustained self-care.

    Digital platform development
    We carried out qualitative research with people with CF (PWCF) using the theoretical domains framework derived from the COMB model (https://doi.org/10.1186/1748-5908-7-37) and identified barriers and facilitators of sustained adherence. Taking these factors into account we worked with PWCF over 14 months from 2015 using agile software design to create a digital platform, CFHealthHub, which presents time and date stamped data from Pari eTracks. CFHealthHub was evaluated in a 2 centre pilot study completed in 2017 and a 600 patient 19 centre RCT will be completed in June 2019. Over the past 18 months a learning health system in 3 adult CF centres has recruited 400 patients to CFHealthHub and involved in the co-production of a clinician facing dashboard emphasising behaviour change supporting the move from rescue to prevention.

    Conclusions
    Sustained adherence requires behaviour change in both patients and their clinical teams that must be built on a clear understanding of the factors that support habit formation and routine.