SMS and Interactive Phone Messages for Medication Adherence Support (MAPS)

1. Medication Adherence for Patients’ Support (MAPS) Would ‘Interactive’ phone and SMS text messages be effective in helping people to take their medicine?

2. MedicationAdherenceforPatients’ Support (MAPS) JB Bio I: Cambridge County Council 1991 – 2006 (MS Access highlights) Access (97) DB for all Jobs/People in (internal) Telephone Directory (Intranet accessible) Access (97) DBs Suite of Environmental Systems, including Rights of Way, Waste Management, Tree Pack Schemes...

3. MedicationAdherenceforPatients’ Support (MAPS) JB Bio II: University of Cambridge 2006 – 2019+ (MS Access highlights) Access (2003) “Generic” DB for administration of participants in a Trial or Study [around 20+ studies to date] Access (2003- -->2016) Code List Database for researchers of ‘Big Data’ Data Management in PCU (staff of 180+)

4. MedicationAdherenceforPatients’ Support (MAPS) The actual title of the (new) protocol : “Development and piloting of a highly tailored digital intervention to support adherence to antihypertensive medications as an adjunct to primary care consultations” (Aikaterini Kassavou, Vikki Houghton, Simon Edwards, James Brimicombe, Stephen Sutton - https://bmjopen.bmj.com/content/9/1/e024121 )

5. MedicationAdherenceforPatients’ Support (MAPS) In English: “Can we, in a low-cost way, timely way -remind people to take their pills – and tailor the messages to their needs for greater effect? ” (estimated £300m prescriptions wasted per year in UK)

6. MedicationAdherenceforPatients’ Support (MAPS) The Researcher’s (new) idea: Recruit (X) participants to a 90-day schedule to receive daily automated phone calls from an IVR system (outgoing phone calls) OR SMS Text messages to both remind them to take meds / give information. Give them a questionnaire to do first... Ppts could join, start ‘Day 1’ at anytime. What messages they get will be ‘tailored’ based on their questionnaire scores.

7. MedicationAdherenceforPatients’ Support (MAPS) The Researcher’s (new) idea (part II): We create the voice messages in Access, just in time for tomorrow The frequency of any messages they get is also something they choose (3 levels of ‘intensity’) The content of the messages– the researcher will write and be able to update on the Database. The researcher will also be able to ‘play’ with the conditions that dictate what voice or SMS message they get... Ppts can phone us or text us back too for more interaction.....!

8. MedicationAdherenceforPatients’ Support (MAPS) Preferences (Times of calls) Q’re B/L Scores Name For each ppt.. Day of Schedule WAV Creation & Scheduling Database Standard messages Nightly Batch C3i IVR Tailored Content & Conditions SFTP Custom WAVs / New ppts info/ Schedule

9. MedicationAdherenceforPatients’ Support (MAPS) Preferences (Times of calls) Q’re B/L Scores Name For each ppt.. Day of Schedule SMS Creation & Scheduling Database Standard messages HourlyBatch 3rd Party SMS?? Tailored Content & Conditions API Custom SMS Texts

10. MedicationAdherenceforPatients’ Support (MAPS) Database Build (1) Data Entry for Q’re B/L data Maintain Participants in ADMIN DB Create standard Schedule for ‘Normal’ or ‘Less’ or ‘More’ over 90 days for phone + texts Create standard messages (non-tailored)

12. MedicationAdherenceforPatients’ Support (MAPS) Database Build (1) – easy bits first..? Data Entry for Q’re B/L data Maintain Participants in ADMIN DB Create standard Schedule for ‘Normal’ or ‘Less’ or ‘More’ over 90 days Create standard messages (non-tailored)

17. MedicationAdherenceforPatients’ Support (MAPS) Database Build (1) – easy bits first..? Data Entry for Q’re B/L data Maintain Participants in ADMIN DB Create standard Schedule for ‘Normal’ or ‘Less’ or ‘More’ over 90 days Create standard messages (non-tailored)

20. MedicationAdherenceforPatients’ Support (MAPS) Database Build (2) – OK.. time to think? Voice Creation from text! what... how..? Batch creation of WAVs & ... SMS Texts... Tailored Content & Rules

21. Interactive Voice Response System Choices for Voices... The Queen of IVR?

22. Interactive Voice Response System Choices for Voices... Surely not .. MICROSOFT ANNA?

23. Interactive Voice Response System Choices for Voices... Surely there are others?! Yes, using MS Speech platform https://www.microsoft.com/en-gb/download/details.aspx?id=27225 https://www.microsoft.com/en-gb/download/details.aspx?id=27224 .. Just can’t see them ?! (can on Windows 10)

24. MedicationAdherenceforPatients’ Support (MAPS) Database Build (2) – OK.. time to think? Voice Creation from text! what... how..? Batch creation of WAVs & SMS Texts... Tailored Content & Rules

25. MedicationAdherenceforPatients’ Support (MAPS) Database Build (2) – OK.. time to think? Re-introducing... Balabolka! http://www.cross-plus-a.com/balabolka.htm

26. MedicationAdherenceforPatients’ Support (MAPS) Command Line Balabolka... "balabolka_console.exe" -t "Then imagine that you take each tablet with this activity" -s 1 -v +100 -p 0 -w "U:\IVRtemp_TMP.wav" -n "HAZEL" -bt 8 -fr 8 -k -ch 1 mCommand = """" & gRootProgram & gBalabolka & """ -t """ & m & """ -s " & mBBSpeed & " -v " & _ mBBVolume& " -p " & mBBPitch & " -w """ & mTargetFileTMP & """ -n """ & mBBVoice & """" & " -bt 8 -fr 8 -k -ch 1" ' Do Balabolka... HIDDEN FROM MAPS as this seems to work OK GlbShellWaitmCommand, vbHide, 18000 GlbSleep 0.5

27. MedicationAdherenceforPatients’ Support (MAPS) Database Build (2) – OK.. time to think? Voice Creation from text! what... how..? Batch creation of WAVs & SMS Texts... Tailored Content & Rules

34. MedicationAdherenceforPatients’ Support (MAPS) For each ppt.. Preferences (Times of calls) Q’re B/L Scores Name Day of Schedule WAV Creation & Scheduling Database Standard messages Nightly Batch C3i IVR Tailored Content & Conditions SFTP WAVs / New ppts Schedule

35. MedicationAdherenceforPatients’ Support (MAPS) Preferences (Times of Texts) Q’re B/L Scores Name For each ppt.. Day of Schedule SMS Creation & Scheduling Database Standard messages HourlyBatch Tailored Content & Conditions API Custom SMS Texts via... FASTSms

36. MedicationAdherenceforPatients’ Support (MAPS) Database Build (3) – Hourly Run Create List of pptsdue SMS messages on the hour .. to take meds within the coming hour

37. MedicationAdherenceforPatients’ Support (MAPS) Database Build (3) – Hourly Run Task scheduled on Windows server (in practice, every 5 mins to hour 6:00am – 23:00) Launch Admin DB – check command line to see if in ‘batch mode’ Query all ACTIVE ppts, if due a message: load a temporary table with all information required for SMS TEXT send.

38. MedicationAdherenceforPatients’ Support (MAPS) Query all ACTIVE ppts, due a message…(1) - qryListPptsCustomSMSFORDATE_1

39. MedicationAdherenceforPatients’ Support (MAPS) Query all ACTIVE ppts, due a message…(2) - qryListPptsCustomSMSFORDATE_2

40. MedicationAdherenceforPatients’ Support (MAPS) The main LOOP round the selected participants due a message...

41. MedicationAdherenceforPatients’ Support (MAPS)

42. MedicationAdherenceforPatients’ Support (MAPS)

43. MedicationAdherenceforPatients’ Support (MAPS) The main LOOP round the selected participants due a message (final)

44. MedicationAdherenceforPatients’ Support (MAPS)

45. MedicationAdherenceforPatients’ Support (MAPS) FASTSMS API

46. MedicationAdherenceforPatients’ Support (MAPS) DEMO

47. MedicationAdherenceforPatients’ Support (MAPS) DEMO (here’s one I sent earlier....)

48. MedicationAdherenceforPatients’ Support (MAPS) LOG of TEXTs sent...

49. MedicationAdherenceforPatients’ Support (MAPS) ... AND report on FAILURES from FASTSMS

50. MedicationAdherenceforPatients’ Support (MAPS)