439 Design and feasibility testing of IDC-VI: a theory-informed intervention to support medication dispensing and counselling for patients with vision impairment

Abstract Introduction Pharmaceutical services for visually impaired (VI) individuals are lacking, both worldwide and in Saudi Arabia (SA). Little evidence exists for effective pharmaceutical interventions to support medicines optimisation in this population (1). The Medical Research Council advocates theory-based intervention development and feasibility testing before full implementation. A feasibility study ‘asks whether something can be done, should we proceed with it, and if so, how’. Aim To design and test the feasibility of IDC-VI (Intervention for Dispensing and Counselling for the Visually Impaired). Methods Phase 1 focused on developing the intervention. Using the theoretical domains framework (TDF) (2), 26 hospital/community pharmacists in SA were interviewed about their dispensing/counselling behaviour with a view to developing an intervention. The research team identified nine key TDF domains and selected eight behaviour change techniques (BCTs) to include in the intervention which could potentially enhance the pharmacist’s knowledge, skills and help them monitor their behaviour. The BCTs were operationalised to produce an intervention package including a training session for pharmacists, behaviour goal setting and review sheets, a checklist with 25 steps to follow during dispensing/counselling (e.g., Ask “What is the best method to provide information about medications to you and/or your caregiver?”), sample patient scenarios, and an intervention record and manual. Phase 2 tested the feasibility of the intervention and study procedures (recruitment, data collection) at two hospital outpatient pharmacies. Two pharmacists, recruited through the pharmacy supervisor, were trained and provided with all intervention materials. Pharmacists were asked to implement the intervention with VI adult patients taking ≥3 medicines. Due to difficulties in identifying patients prior to attending the pharmacy, records of those requesting refills for out-of-stock medicines were used to recruit patients. Outcomes focused on the feasibility of recruitment, and collecting data on pharmacists’ experience and patients’ medicines/medical conditions. Pharmacists and patients provided feedback through interviews and telephone-administered questionnaires, respectively. Descriptive statistics and thematic analysis were used to analyse data. Results Two pharmacists implemented the IDC-VI with five patients. The patient recruitment process was practical at the time, but not f