Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)

Brown, Sarah L; McDonnell, Barry J; McRae, David; Angel, Paul; Khan, Imtiaz; Phillips, Rhiannon; Hallingberg, Britt; James, Delyth

doi:10.1371/journal.pone.0339871

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Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)

Sarah L Brown

, Barry J McDonnell

, David McRae, Paul Angel, Imtiaz Khan, Rhiannon Phillips, Britt Hallingberg, Delyth James

PLOS One, Volume: 21, Issue: 1, Start page: e0339871

Swansea University Author: Delyth James

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DOI (Published version): 10.1371/journal.pone.0339871

Abstract

Using visualisation to conceptualise a chronic condition can encourage accurate illness beliefs and support treatment adherence. Hi-BP is a digital visual intervention to support adherence to antihypertensive medication, co-produced with patients. The aim of this study was to investigate the feasibi...

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Published in:	PLOS One
ISSN:	1932-6203
Published:	Public Library of Science (PLOS) 2026
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa71233

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spelling	2026-01-13T10:36:38.3871938 v2 71233 2026-01-13 Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP) dc24cdd4d09d96fa49a0f213d1060cf9 0000-0001-7434-7064 Delyth James Delyth James true false 2026-01-13 MEDS Using visualisation to conceptualise a chronic condition can encourage accurate illness beliefs and support treatment adherence. Hi-BP is a digital visual intervention to support adherence to antihypertensive medication, co-produced with patients. The aim of this study was to investigate the feasibility and acceptability of Hi-BP and explore the preliminary direction of effects on illness and treatment beliefs, medication adherence and blood pressure (BP). A two-phased mixed-methods non-randomised feasibility study was conducted from April 2021 to March 2022 in eight community pharmacies across one Health Board in South-East Wales, UK. Hi-BP was delivered as a single researcher-led consultation to 69 patients in Phase 1 and by pharmacists to three patients in Phase 2. Feasibility was determined using predefined criteria, with acceptability explored qualitatively using semi-structured interviews. Quantitative outcome measures (illness perceptions, medication beliefs, medication-adherence, prescription dispensing and collection data, BP) were recorded at baseline and immediately post-intervention.Follow-up outcome measures were collected at two-weeks (medication-adherence) and three-months (all baseline measures). Hi-BP met feasibility criteria for pharmacist recruitment in both phases, and patient recruitment in Phase 1, but not Phase 2. Hi-BP was acceptable to the sub-sample of 15 patient participants interviewed in Phase 1; insufficient data were available to determine patient acceptability at Phase 2. Hi-BP was acceptable to pharmacists in Phase 1 and partially acceptable at Phase 2, due to competing demands on time for intervention delivery. All outcome measures were considered feasible for use, though a ceiling effect was noted for medication adherence. A potentially positive directional effect was found for illness perceptions (X2(2)=10.83,n=54,p=0.004), medication beliefs (BMQ-Necessity (X2(2)=11.71,n=54,p=0.003) and BP (Systolic BP Z=-3.91,n=51,p=<0.001) but not for medication adherence (MARS-5 X2(2)= 2.4,n=45,p=0.299). In the Community Pharmacy setting, Hi-BP was well-accepted and has the potential for significant reductions in BP; however, further research is needed to explore pharmacist capacity to support implementation. Journal Article PLOS One 21 1 e0339871 Public Library of Science (PLOS) 1932-6203 2 1 2026 2026-01-02 10.1371/journal.pone.0339871 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study was completed as part of a PhD funded by Knowledge Economy Skills Scholarships (KESS2) in partnership with Cwm Taf Morgannwg University Health Board. 2026-01-13T10:36:38.3871938 2026-01-13T10:27:59.7851327 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy Sarah L Brown 0000-0002-9741-1935 1 Barry J McDonnell 0000-0001-5912-1278 2 David McRae 3 Paul Angel 4 Imtiaz Khan 5 Rhiannon Phillips 6 Britt Hallingberg 7 Delyth James 0000-0001-7434-7064 8 71233__35976__7fcb04c762c5492a993a0c2f48dcdfb2.pdf 71233.VOR.pdf 2026-01-13T10:34:17.6696745 Output 1337914 application/pdf Version of Record true © 2026 Brown et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
spellingShingle	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP) Delyth James
title_short	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
title_full	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
title_fullStr	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
title_full_unstemmed	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
title_sort	Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)
author_id_str_mv	dc24cdd4d09d96fa49a0f213d1060cf9
author_id_fullname_str_mv	dc24cdd4d09d96fa49a0f213d1060cf9_***_Delyth James
author	Delyth James
author2	Sarah L Brown Barry J McDonnell David McRae Paul Angel Imtiaz Khan Rhiannon Phillips Britt Hallingberg Delyth James
format	Journal article
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container_start_page	e0339871
publishDate	2026
institution	Swansea University
issn	1932-6203
doi_str_mv	10.1371/journal.pone.0339871
publisher	Public Library of Science (PLOS)
college_str	Faculty of Medicine, Health and Life Sciences
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department_str	Swansea University Medical School - Pharmacy{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Pharmacy
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description	Using visualisation to conceptualise a chronic condition can encourage accurate illness beliefs and support treatment adherence. Hi-BP is a digital visual intervention to support adherence to antihypertensive medication, co-produced with patients. The aim of this study was to investigate the feasibility and acceptability of Hi-BP and explore the preliminary direction of effects on illness and treatment beliefs, medication adherence and blood pressure (BP). A two-phased mixed-methods non-randomised feasibility study was conducted from April 2021 to March 2022 in eight community pharmacies across one Health Board in South-East Wales, UK. Hi-BP was delivered as a single researcher-led consultation to 69 patients in Phase 1 and by pharmacists to three patients in Phase 2. Feasibility was determined using predefined criteria, with acceptability explored qualitatively using semi-structured interviews. Quantitative outcome measures (illness perceptions, medication beliefs, medication-adherence, prescription dispensing and collection data, BP) were recorded at baseline and immediately post-intervention.Follow-up outcome measures were collected at two-weeks (medication-adherence) and three-months (all baseline measures). Hi-BP met feasibility criteria for pharmacist recruitment in both phases, and patient recruitment in Phase 1, but not Phase 2. Hi-BP was acceptable to the sub-sample of 15 patient participants interviewed in Phase 1; insufficient data were available to determine patient acceptability at Phase 2. Hi-BP was acceptable to pharmacists in Phase 1 and partially acceptable at Phase 2, due to competing demands on time for intervention delivery. All outcome measures were considered feasible for use, though a ceiling effect was noted for medication adherence. A potentially positive directional effect was found for illness perceptions (X2(2)=10.83,n=54,p=0.004), medication beliefs (BMQ-Necessity (X2(2)=11.71,n=54,p=0.003) and BP (Systolic BP Z=-3.91,n=51,p=<0.001) but not for medication adherence (MARS-5 X2(2)= 2.4,n=45,p=0.299). In the Community Pharmacy setting, Hi-BP was well-accepted and has the potential for significant reductions in BP; however, further research is needed to explore pharmacist capacity to support implementation.
published_date	2026-01-02T05:31:51Z
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Visualisation of hypertension: A non-randomised pilot study to explore the feasibility of a Community Pharmacy-based intervention to support medication adherence (Hi-BP)

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