Co-designing use of a digital test in ADHD medication management
Summary
QBTest is a digital test that measures markers of ADHD through camera and other tracking while the user performs tasks. It’s used to gauge whether someone’s medication is at the right dose by assessing their symptoms whilst on medication. To help it be testable within NHS care, we ran co-design workshops with clinicians and patients (combined) to decide how best to use QBTest in patient visits, as part of a trial. The design was then used in a trial, and recruited and retained participants better than usual (i.e. better than trials that aren’t co-designed), because flows and processes fitted user needs.
Finding consensus between clinicians and families on how to make it work
A team of six researchers delivered three workshops, each a month apart, to design different parts of the patient journey and how it fitted within clinicians’ workloads:
3 x consensus workshops with stakeholders (21 participants, with most attending at least two workshops)
Stakeholders were: clinicians, parents of children with ADHD, QBTest owners (QBTech), researchers
The aim was to develop consensus about the most suitable patient journey and the tasks that would be involved, balancing differing needs of its various users and stakeholders to increase the likelihood of trial success. Workshops helped stakeholders identify important design issues and solve problems together.
Design decisions were made and agreed in the workshops. The final product was a co-designed study ‘protocol’ (i.e. in depth design) for a trial which then took place. This was novel, because studies aren’t usually designed with this high level of stakeholder input.
A different but more effective design
The study design decisions were very different to what would have been decided without all stakeholders present. Decisions were deemed optimum bearing in mind the different and sometimes conflicting needs that had been identified. Key changes included:
● greatly reducing repetition of measures, to reduce the number of participants dropping out
● changing frequency and timing of activities to fit around clinicians’ capacity
● agreeing what counted as an ‘optimum dose’ of medication from the different perspectives
● identifying the most meaningful measures of success
The final study design was used in a trial and was a success, even in a clinical area where recruitment is difficult and dropout is high. This showed the design had been a success in fitting the needs of its different users, and co-designing with stakeholders was crucial in achieving this.
Workshops enabled problem identification and solving between stakeholders whose needs sometimes conflicted, but were able to optimise solutions through open discussion. They helped overcome key barriers that wouldn’t normally have been considered.
To find out more, you can see the study publication: https://bit.ly/3ZYZC99
Or visit the QBTech website:www.qbtech.com