Project AMM35

IMAB-Qi: Identification of Medication Adherence Barriers intervention

This study will aim to develop a trial to evaluate a medication adherence intervention to enhance structured medication reviews in primary care.


One in two people don’t take their medicines correctly and there are usually several reasons for this. When medicines aren’t taken correctly, health can get worse which also increases NHS costs like more hospital visits. Supporting people to take their medicines correctly is a government priority so pharmacists have been introduced into doctor’s surgeries to help. The problem is that patients and healthcare professionals struggle to find a patient’s main reasons for not taking medicines correctly. This makes it difficult to find solutions.

Over the last ten years we have worked with patients, healthcare professionals and researchers to develop the ‘Identification of Medication Adherence Barriers Questionnaire’ (IMAB-Q)’. The IMAB-Q has 10 questions that help healthcare professionals and patients find out the main reasons for a person not taking their medicines correctly. It also has a list of solutions for each reason that the patient can pick from.

We want to give pharmacists in doctor’s surgeries the IMAB-Q to use with their patients and test whether it helps and is good value for money for the NHS.

Project aims

To help design a study testing IMAB-Q used by pharmacists in doctor’s surgeries we need to:

  1. Create a group of patients, carers and professionals to advise us. We will call this group the Primary Care Influencer Group.
  2. Agree the most important things to measure in our study. This is called a Core Outcome Set.
  3. Agree which patients to include in the trial and how to identify them.
  4. Create a research team with the right skills and experience.
  5. Submit a grant application using learning from the first four points.

Project activity 

Project plan:

  • Phase 1 (months 1-3): We will set-up a group of senior voices representing patients, carers and professionals from healthcare, social care and local authorities. This group will help us design the trial to test the IMAB-Q and tell us which other types of people we should work with.
  • Phase 2 (months 3-10): We will use previous studies to develop an online questionnaire of the potential things to measure in any study to help people take their medicines correctly. We will ask researchers, professionals and patients to pick the most important ones. We will then invite some of them to a workshop to agree which groups of patients to include in the IMAB-Q trial, how to identify them and which professionals other than pharmacists should be involved.
  • Phase 3 (months 7-12): We will work with the group of senior voices and other researchers to prepare and submit a grant for the IMAB-Q trial.



  • Easthall C, Taylor N, Bhattacharya D. Barriers to medication adherence in patients prescribed medicines for the prevention of cardiovascular disease: a conceptual framework. Int J Pharm Pract. 2018.
  • Wali N, Renzaho A, Wang X, Atkins B, Bhattacharya D. Do interventions to improve adherence to antiretroviral therapy recognise diversity? A systematic review. AIDS care. 2020:1-15.


Report – IMAB-Q validation and feasibility:

Who is involved? 

  • Principal investigator: Prof Debi Bhattacharya, University of Leicester/ University of East Anglia
  • Dr Sion Scott, University of Leicester (study co-lead investigator)
  • Dr Allan Clark, University of East Anglia
  • Professor David Wright, University of Leicester
  • Mr David Turner, University of East Anglia
  • Dr Kumud Kantilal, University of East Anglia/ University of Leicester

Contact us

Prof Debi Bhattacharya