Evidence and the use of theory in health services research in pharmacy

This chapter outlines the approach to using theory in the development of complex interventions. A complex intervention can be defined as one which has a number of interacting components, and it is these components which bring about change through the implementation of the intervention. Reference is made to the Medical Research Council Framework on developing and evaluating complex interventions, and how this Framework has been used in the development of two theoretically grounded interventions targeting the prescribing of and adherence to polypharmacy, with a focus on behavior change. Each step in intervention development is described, the role of theory, and the importance of considering evidence, context, and experience in selecting and combining intervention components. Finally, consideration of feasibility and pilot testing of interventions is advocated to provide an opportunity to refine and test intervention components in terms of implementation and acceptability.