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Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model

E. Mantzourani, Delyth James Orcid Logo, M.A. Akthar, S.L. Brown, R. Yemm, E.C. Lehnbom, J.R. Hanrahan, C.H. Seage

Exploratory Research in Clinical and Social Pharmacy, Volume: 13, Start page: 100393

Swansea University Author: Delyth James Orcid Logo

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DOI (Published version): 10.1016/j.rcsop.2023.100393

Abstract

BackgroundPharmacy professionals are well-placed to provide medication adherence support to patients. The Capability, Opportunity, Motivation-Behaviour (COMsingle bondB) and Theoretical Domains Framework (TDF) are two complementary models previously applied to medication-taking behaviour. Understand...

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Published in: Exploratory Research in Clinical and Social Pharmacy
ISSN: 2667-2766
Published: Elsevier BV 2024
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2025-07-15T11:17:15.1155007</datestamp><bib-version>v2</bib-version><id>69687</id><entry>2025-06-11</entry><title>Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model</title><swanseaauthors><author><sid>dc24cdd4d09d96fa49a0f213d1060cf9</sid><ORCID>0000-0001-7434-7064</ORCID><firstname>Delyth</firstname><surname>James</surname><name>Delyth James</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-06-11</date><deptcode>MEDS</deptcode><abstract>BackgroundPharmacy professionals are well-placed to provide medication adherence support to patients. The Capability, Opportunity, Motivation-Behaviour (COMsingle bondB) and Theoretical Domains Framework (TDF) are two complementary models previously applied to medication-taking behaviour. Understanding the patient-specific barriers and facilitators to adherence using psychological frameworks from the early stages of pharmacy education enables the design and delivery of effective interventions.ObjectivesTo examine whether a novel &#x2018;mock medicine&#x2019; learning activity enabled students to experience the range of barriers and facilitators to medication adherence using the COM-B and TDF.MethodsA mock medicine activity was conducted with students at pharmacy schools in three universities in the UK, Norway, and Australia over one week. Percentage adherence was calculated for five dosing regimens; theoretical framework analysis was applied to map reflective statements from student logs to COM-B and TDF.ResultsA total of 349 students (52.6%) returned completed logs, with high overall mean adherence (83.5%, range 0&#x2013;100%). Analysis of the 277 (79.4%) students who provided reflective statements included barriers and facilitators that mapped onto one (9%), two (29%) or all three (62%) of the COM-B components and all fourteen TDF domains (overall mean = 4.04; Uni 1 = 3.72; Uni 2 = 4.50; Uni 3 = 4.38; range 1&#x2013;8). Most frequently mapped domains were &#x2018;Environmental context and resources&#x2019; (n = 199; 72%), &#x2018;Skills&#x2019; (n = 186; 67%), &#x2018;Memory, attention and decision-making&#x2019; (184; 66%) and &#x2018;Beliefs about capabilities&#x2019; (n = 175; 63%).ConclusionsThis is the first study to utilise both COM-B and TDF to analyse a proxy measure of medication adherence in pharmacy education. Data mapping demonstrated that students experienced similar issues to patients when prescribed a short course of medication. Importantly, all the factors influencing medication-taking reported by students were captured by these two psychological frameworks. Future educational strategies will involve students in the mapping exercise to gain hands-on experience of using these psychological constructs in practice.</abstract><type>Journal Article</type><journal>Exploratory Research in Clinical and Social Pharmacy</journal><volume>13</volume><journalNumber/><paginationStart>100393</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2667-2766</issnPrint><issnElectronic/><keywords>Theoretical Domains Framework (TDF); COM-B model; Medication adherence; Pharmacy education; Behaviour change, psychological frameworks</keywords><publishedDay>1</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-03-01</publishedDate><doi>10.1016/j.rcsop.2023.100393</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders/><projectreference/><lastEdited>2025-07-15T11:17:15.1155007</lastEdited><Created>2025-06-11T14:36:35.4509508</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Pharmacy</level></path><authors><author><firstname>E.</firstname><surname>Mantzourani</surname><order>1</order></author><author><firstname>Delyth</firstname><surname>James</surname><orcid>0000-0001-7434-7064</orcid><order>2</order></author><author><firstname>M.A.</firstname><surname>Akthar</surname><order>3</order></author><author><firstname>S.L.</firstname><surname>Brown</surname><order>4</order></author><author><firstname>R.</firstname><surname>Yemm</surname><order>5</order></author><author><firstname>E.C.</firstname><surname>Lehnbom</surname><order>6</order></author><author><firstname>J.R.</firstname><surname>Hanrahan</surname><order>7</order></author><author><firstname>C.H.</firstname><surname>Seage</surname><order>8</order></author></authors><documents><document><filename>69687__34765__f3b84e24e2274e77872c75a785d2df32.pdf</filename><originalFilename>69687.VoR.pdf</originalFilename><uploaded>2025-07-15T11:15:07.8981292</uploaded><type>Output</type><contentLength>3778960</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2023 The Authors. 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spelling 2025-07-15T11:17:15.1155007 v2 69687 2025-06-11 Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model dc24cdd4d09d96fa49a0f213d1060cf9 0000-0001-7434-7064 Delyth James Delyth James true false 2025-06-11 MEDS BackgroundPharmacy professionals are well-placed to provide medication adherence support to patients. The Capability, Opportunity, Motivation-Behaviour (COMsingle bondB) and Theoretical Domains Framework (TDF) are two complementary models previously applied to medication-taking behaviour. Understanding the patient-specific barriers and facilitators to adherence using psychological frameworks from the early stages of pharmacy education enables the design and delivery of effective interventions.ObjectivesTo examine whether a novel ‘mock medicine’ learning activity enabled students to experience the range of barriers and facilitators to medication adherence using the COM-B and TDF.MethodsA mock medicine activity was conducted with students at pharmacy schools in three universities in the UK, Norway, and Australia over one week. Percentage adherence was calculated for five dosing regimens; theoretical framework analysis was applied to map reflective statements from student logs to COM-B and TDF.ResultsA total of 349 students (52.6%) returned completed logs, with high overall mean adherence (83.5%, range 0–100%). Analysis of the 277 (79.4%) students who provided reflective statements included barriers and facilitators that mapped onto one (9%), two (29%) or all three (62%) of the COM-B components and all fourteen TDF domains (overall mean = 4.04; Uni 1 = 3.72; Uni 2 = 4.50; Uni 3 = 4.38; range 1–8). Most frequently mapped domains were ‘Environmental context and resources’ (n = 199; 72%), ‘Skills’ (n = 186; 67%), ‘Memory, attention and decision-making’ (184; 66%) and ‘Beliefs about capabilities’ (n = 175; 63%).ConclusionsThis is the first study to utilise both COM-B and TDF to analyse a proxy measure of medication adherence in pharmacy education. Data mapping demonstrated that students experienced similar issues to patients when prescribed a short course of medication. Importantly, all the factors influencing medication-taking reported by students were captured by these two psychological frameworks. Future educational strategies will involve students in the mapping exercise to gain hands-on experience of using these psychological constructs in practice. Journal Article Exploratory Research in Clinical and Social Pharmacy 13 100393 Elsevier BV 2667-2766 Theoretical Domains Framework (TDF); COM-B model; Medication adherence; Pharmacy education; Behaviour change, psychological frameworks 1 3 2024 2024-03-01 10.1016/j.rcsop.2023.100393 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee 2025-07-15T11:17:15.1155007 2025-06-11T14:36:35.4509508 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy E. Mantzourani 1 Delyth James 0000-0001-7434-7064 2 M.A. Akthar 3 S.L. Brown 4 R. Yemm 5 E.C. Lehnbom 6 J.R. Hanrahan 7 C.H. Seage 8 69687__34765__f3b84e24e2274e77872c75a785d2df32.pdf 69687.VoR.pdf 2025-07-15T11:15:07.8981292 Output 3778960 application/pdf Version of Record true © 2023 The Authors. This is an open access article under the CC BY-NC-ND license. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
spellingShingle Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
Delyth James
title_short Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
title_full Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
title_fullStr Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
title_full_unstemmed Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
title_sort Can a mock medication-taking learning activity enable pharmacy students to experience the range of barriers and facilitators to medication adherence? An analysis informed by the Theoretical Domains Framework and COM-B model
author_id_str_mv dc24cdd4d09d96fa49a0f213d1060cf9
author_id_fullname_str_mv dc24cdd4d09d96fa49a0f213d1060cf9_***_Delyth James
author Delyth James
author2 E. Mantzourani
Delyth James
M.A. Akthar
S.L. Brown
R. Yemm
E.C. Lehnbom
J.R. Hanrahan
C.H. Seage
format Journal article
container_title Exploratory Research in Clinical and Social Pharmacy
container_volume 13
container_start_page 100393
publishDate 2024
institution Swansea University
issn 2667-2766
doi_str_mv 10.1016/j.rcsop.2023.100393
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Pharmacy{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Pharmacy
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description BackgroundPharmacy professionals are well-placed to provide medication adherence support to patients. The Capability, Opportunity, Motivation-Behaviour (COMsingle bondB) and Theoretical Domains Framework (TDF) are two complementary models previously applied to medication-taking behaviour. Understanding the patient-specific barriers and facilitators to adherence using psychological frameworks from the early stages of pharmacy education enables the design and delivery of effective interventions.ObjectivesTo examine whether a novel ‘mock medicine’ learning activity enabled students to experience the range of barriers and facilitators to medication adherence using the COM-B and TDF.MethodsA mock medicine activity was conducted with students at pharmacy schools in three universities in the UK, Norway, and Australia over one week. Percentage adherence was calculated for five dosing regimens; theoretical framework analysis was applied to map reflective statements from student logs to COM-B and TDF.ResultsA total of 349 students (52.6%) returned completed logs, with high overall mean adherence (83.5%, range 0–100%). Analysis of the 277 (79.4%) students who provided reflective statements included barriers and facilitators that mapped onto one (9%), two (29%) or all three (62%) of the COM-B components and all fourteen TDF domains (overall mean = 4.04; Uni 1 = 3.72; Uni 2 = 4.50; Uni 3 = 4.38; range 1–8). Most frequently mapped domains were ‘Environmental context and resources’ (n = 199; 72%), ‘Skills’ (n = 186; 67%), ‘Memory, attention and decision-making’ (184; 66%) and ‘Beliefs about capabilities’ (n = 175; 63%).ConclusionsThis is the first study to utilise both COM-B and TDF to analyse a proxy measure of medication adherence in pharmacy education. Data mapping demonstrated that students experienced similar issues to patients when prescribed a short course of medication. Importantly, all the factors influencing medication-taking reported by students were captured by these two psychological frameworks. Future educational strategies will involve students in the mapping exercise to gain hands-on experience of using these psychological constructs in practice.
published_date 2024-03-01T05:28:51Z
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