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

2. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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 ( >2016) Code List Database for researchers of ‘Big Data’
Data Management in PCU (staff of 180+)

4. Medication Adherence for Patients’ 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 - )

5. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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.
They wil have follow-up q’res also, but we’re not actually interested in the science here...

7. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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
Custom WAVs /
New ppts info/ Schedule

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

10. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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
.. Just can’t see them ?!
(can on Windows 10)

24. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ Support (MAPS)
Database Build (2) – OK.. time to think?
Re-introducing... Balabolka!

26. Medication Adherence for Patients’ Support (MAPS)
Command Line Balabolka...
"balabolka_console.exe"
-t "Then imagine that you take each tablet with this activity"
-s 1 -v 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
GlbShellWait mCommand, vbHide, 18000
GlbSleep 0.5

27. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ Support (MAPS)
For each ppt..
Preferences
(Times of Texts)
Q’re B/L Scores
Name
Day of Schedule
SMS Creation & Scheduling Database
Standard messages
Hourly Batch
Tailored Content & Conditions
API
Custom SMS Texts via...
FASTSms

36. Medication Adherence for Patients’ Support (MAPS)
Database Build (3) – Hourly Run
Create List of ppts due SMS messages on the hour
.. to take meds within the coming hour

37. Medication Adherence for Patients’ 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. Medication Adherence for Patients’ Support (MAPS)
Query all ACTIVE ppts, due a message…(1) - qryListPptsCustomSMSFORDATE_1

39. Medication Adherence for Patients’ Support (MAPS)
Query all ACTIVE ppts, due a message…(2) - qryListPptsCustomSMSFORDATE_2

40. Medication Adherence for Patients’ Support (MAPS)
The main LOOP round the selected participants due a message...

41. Medication Adherence for Patients’ Support (MAPS)

42. Medication Adherence for Patients’ Support (MAPS)

43. Medication Adherence for Patients’ Support (MAPS)
The main LOOP round the selected participants due a message (final)

44. Medication Adherence for Patients’ Support (MAPS)

45. Medication Adherence for Patients’ Support (MAPS)
FASTSMS API

46. Medication Adherence for Patients’ Support (MAPS)
DEMO

47. Medication Adherence for Patients’ Support (MAPS)
DEMO (here’s one I sent earlier....)

48. Medication Adherence for Patients’ Support (MAPS)
LOG of TEXTs sent...

49. Medication Adherence for Patients’ Support (MAPS)
... AND report on FAILURES from FASTSMS

50. Medication Adherence for Patients’ Support (MAPS)

51. Thanks for your attention! Any questions / code to view...?
Medication Adherence for Patients’ Support (MAPS)
Thanks for your attention!
Any questions / code to view...?