myCare Start Implementation study (myCare Start-I)

Implementation of a new model of care for supporting adherence in people starting a new medication for a long-term condition

myCare Start-I is a national implementation science project coordinated by the University of Geneva with the objective to adapt, implement and evaluate the myCare Start service in Switzerland. The project aims to enhance fit of the service in the Swiss context at the patient, provider and societal levels.

Methodology

The myCare Start-I project comprises two phases focusing on adaptation (Phase A), implementation and evaluation (Phase B). Each of these phases were divided in different Work Package (WP) (Figure 1).

Figure 1. Implementation Pathway for myCare Start-I

 

Phase A (2022-2025)

  • WP1 Stakeholder engagement: to engage key stakeholders within the Swiss primary care ecosystem to contribute to the creation of a Swiss interprofessional myCare Start service.
  • WP2 Understand the context: undertake a comprehensive contextual analysis as a foundational phase to inform subsequent steps of the myCare Start-I project. The contextual analysis will build on existing evidence on implementation barriers in the real-world from international and Swiss studies and better understand the health care context here in Switzerland.
  • WP3 Adapt the intervention and select context-appropriate implementation strategies: the existing myCare Start service will be adapted to suit the Swiss context and contextually appropriate implementation strategies will be selected using a process of co-creation with stakeholders.
  • WP4 Feasibility testing: The adapted intervention and implementation strategy package will be tested in a small number of pharmacies to ensure fit.

Phase B (2025-2026)

  • WP5 and WP6 Implementation and evaluation of the adapted myCare Start model: A monocentric, Hybrid Type 2 effectiveness-implementation (stepped wedge cluster randomised control design) will be conducted in a maximum of 40 community pharmacist-physician clusters in the French-and German-speaking regions of Switzerland. The study will evaluate the myCare Start service in terms of effectiveness (clinical effectiveness (medication adherence) and cost-effectiveness of the service), and implementation (multi-levelled (patient, pharmacist, physician) implementation outcomes, including acceptability, adoption, appropriateness, fidelity, feasibility, and implementation costs).

Expected Benefit/Relevance

myCare Start will be the first innovative, interprofessional, integrative care model to support medication adherence in chronically ill patients that has been tailored to the Swiss context and developed alongside key stakeholders. Collective efforts to improve patient adherence to long-term therapy may improve patient therapeutic outcomes, safeguard patient safety and alleviate the financial burden on patients and the health system. The project will inform future scale-up.

 

Universität Genf: Forschungsgruppe zu Medikamentenadhärenz und Interprofessionalität

mycarestart(at)unige.ch