SPUR™ Tool Research Plan Completion

Publication in the British Medical Journal Open

Read the scientific communication here

After 4 years of research and already 5 studies published, Observia is thrilled to announce the completion of its Phase 2 research plan with the publication of the final study for this series in the prestigious British Medical Journal Open.
This study was made possible thanks to a fruitful partnership with Kingston University, Kingston Hospital, the National Pharmacy Association, and additional funding from the NPA’s Health Education Foundation.

Adherence, defined as the extent to which patients take their medicines as prescribed, is at the heart of Observia’s vision for better healthcare. Deeply convinced that improving adherence could dramatically improve patients’ lives, the company focused its R&D efforts on understanding the reasons for non-adherence, which can often prevent patients from deriving all the expected benefits of their treatment.
To reach this goal, Observia developed a behavioral diagnostic tool, SPUR. Its purpose is to shed light on the complexity of patients’ health behaviors, and to decipher the reasons for non-adherence that will support the design and delivery of tailored health interventions to address individual patients’ needs.

Today, SPUR’s research plan, which started in 2017, is complete.

Finalization of a 4-year research plan

It began with the establishment of the academic foundations of the SPUR model (Phase 0), a qualitative phase including the review of +100 health questionnaires, allowing the conception of the original 45 questions related to adherence and health behaviors (Phase 1); finally a quantitative phase was conceptualized, aiming to test the statistic model of the tool and refine its algorithm (Phase 2).
The Phase 2 study, published in the British Medical Journal Open, constitutes the final scientific publication to complete this research series.
The objective of this study, conducted by Kingston University’s Department of Pharmacy, was to test the SPUR tool, originally designed with 45 questions, and evaluate how effective it was at measuring adherence. In total, 378 patients living with Type 2 Diabetes were recruited through Kingston Hospital and community pharmacies in South West London, with the support of the National Pharmacy Association and partial funding from the NPA’s Health Education Foundation.
SPUR was compared to other Patient Reported Outcomes Measures (PROMs) as well as patients’ HbA1c and Medication Possession Ratio scores as objective measures of adherence.


The results demonstrated that SPUR was the most reliable measure of medication adherence in the study, whilst also providing information about patient behavior. SPUR was also associated with social factors that relate to medication adherence such as a patient’s income, age, and body weight, providing further evidence that SPUR is a holistic tool.
SPUR was proven to be able to identify differences in medication adherence in patients living with Type 2 Diabetes. This study also shows that the SPUR tool gives a holistic indication of the types of behaviors that affect the way patients take their medicine, which is a critical component for designing tailored intervention strategies.


This study was made possible by the successful collaboration between Observia and its research partners.
The study was conducted by Joshua Wells, Lead investigator for the UK study and PhD Candidate, as well as Professor Reem Kayyali, Chief Investigator for the UK study and Head of Kingston University’s Department of Pharmacy. Patients were recruited through Kingston Hospital with support from the research department and Diabetes Clinical Nurse Specialist team, led by Claire Neely, Consultant Nurse in Diabetes. Finally, the study was partially funded thanks to the National Pharmacy Association’s Health Education Foundation grant, which supported the community pharmacist-led recruitment of patients across South West London.

Listen to the our Lead Researcher

Want to get the behind-the-scenes of this study? Listen to Joshua Wells, 4th year PhD candidate and Lead Researcher for this study. 


                                                   Read the press release


See also

Scientific communications

A multiple-cohort analysis of the SPUR 6/24 patient-reported adherence tool


Clinical Ink and Observia: Pioneering Personalized Patient Engagement in Clinical Trials


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