Improving the safety and continuity of medicines management at care transitions (ISCOMAT) for people with heart failure



To design and test a complex intervention to make best use of medicines and reduce harm through effective medicines management for heart failure patients from hospital discharge and across the primary care transition.


  • WP1 (month 1-15) is a systems/human factors analysis to map and evaluate the cardiology medicines management pathway
  • WP2 (month 6-15) is a patient-led, experience-based co-design (EBCD) process to address patient information and staff training needs at care transitions.
  • WP3 (month 16-24) is a mixed method feasibility study with 30 patients across three health economies to establish the optimum implementation process for the intervention, assess usability and acceptability, identify implementation barriers and facilitators, and test our proposed data collection methods.
  • WP4 (month 16-68) is a 1:1 randomised, controlled cluster trial (WP4a) incorporating a comprehensive economic evaluation, and a process evaluation (WP4b). 


Avoidable harm associated with medicines is widespread - particularly at care transitions and unintended discrepancies in patients’ medicines after discharge from hospital affect more than half of all patients. Patients with heart failure need particular attention if proven medicines–related benefits in delayed disease progression and reduced mortality are to be realised. Our programme will develop and test a co-designed, theory-underpinned, and fully costed complex intervention for patients with heart failure.


Blenkinsopp, Turner, Gardner, Kellar, Farrin, Wright, Longo, Kirkpatrick, Silcock, Holloway, Alldred, Mohammed, Gale, Alderson, Raynor

Funding body: NIHR Programme Grants for Applied Research. (£2,074,179)

Contact: Professor David Alldred and Professor DK Theo Raynor