Table 2 Thematic analysis results

Participant ID, age, and tested delivery mode

 1

“No, no, everything was straightforward really. There was nothing at all that stood out as being awkward about it, or difficult.”

Participant 7, M, age 70–79, text

 2

“Logical, smooth interface, easy to navigate.”

Participant 9, M, age 60–69, text and app

 3

“No, it’s just a straightforward message, have I taken all my meds? Which I suppose if I hadn’t, it would have made me think, well have I?”

Participant 1, M, age 70–79, text

 4

“P: It’s almost patronising”

“I: Okay, so do you have any suggestions of how we might try and change that so it’s not so as annoying or patronising?

P: Well maybe less frequency”

Participant 16, M, age 60–69, text

 5

“Because it’s a different that was every day, you know it’s not going to be the same message so you’re going to pay attention and read it, and reading it should reinforce in your mind ah, I need to take my tablets.”

Participant 9, M, age 60–69, text and app

 6

“This tab (with feedback on behaviour), for me personally, did I stick to the right times, how far off was I, how was I on, do you know what I mean? That sort of information, for me, would have been yes, great. Say after about a week or a month you could look and think what’s going on here?”

Participant 18, M, age 60 to 69, text and app

 7

“I: Would you have any reservations about us using GPS data?

P: None at all. I think that’s probably better than messages coming through when you’re out and when you’re driving or shopping, say you say. It’s rather intrusive. If anything comes through when I’m driving, it has to wait until I’ve finished driving. I don’t even acknowledge it.”

Participant 1, M, age 70–79, text

 8

“Simply because the greater the likelihood of getting the message, I don’t know, would equivocally improve delivery of the message.”

Participant 14, F, age 60–69, text

Participant ID, age, and tested delivery mode

 9

“I: So, it makes you think back onto the past week and reflect?

P: Yes, yes. And you think, let me look at my tablets, to see if there’s as many left as there ought to be?”

Participant 1, M, age 70–79, text

 10

“Whereas, if it goes off in your pocket and you think I will get it after, but about 5 o’clock or something it goes off in your pocket and you think oh, I better get this. Have you taken your medicine? No, I haven’t, so then I’ve got to then go upstairs, view it and then press yes. So, then it’s forced on me, if you like, to make sure I do take it.”

Participant 18, M, age 60 to 69, text and app

 11

“I was waiting for the alarm to go off. Then it was about 20 minutes late, but I was already there with the tablets to take anyway. So, it’s made me take them, even though I didn’t get the alarm at eight o’clock, if you see what I mean. So, that was fine. So, I had taken them anyway because that’s made me more aware that I should take them at that time rather than any time, at random times.”

Participant 15, F, age 60–69, text

 12

“P: Well, yes just exactly what I mean, being committed to take your tablets as prescribed because it’s for your own benefit.”

Participant 1, M, age 70–79, text

 13

“I do think it does help if people feel as though they’re involved (with taking their medications)”

Participant 20, F, age 70–79, text

 14

“To me, that’s saying have you taken it yes or not, I suppose you could lie about it but if you’re going to do that what’s the point of having the text message, I don’t see the point. But yes, it’s an interactive thing isn’t it? So, you’re taking ownership, if you like and dealing with it that way.”

Participant 18, M, age 60 to 69, text and app

 15

“P: What’s the next one? ‘Tablets are part of your self-care.’ I think that was the last message. It’s a reminder that the ultimate responsibility lies with yourself, so take ownership… People don’t take enough personal responsibility. So, if you like, that was quite a good reminder – well actually your meds are down to you and nobody else. You are prescribed them, but you’ve got to take them.”

Participant 9, M, age 60–69, text and app

 16

“If you just get a reminder all the time and it goes off in your pocket, you think it’s just a text, I’ll answer it later. If you think that oh, that could be about my medication and I’m going to have to respond yes or no, then you take it out and you’re going to look at it and you’re taking ownership of your responsibility obviously it’s your anyway for taking your meds.”

Participant 18, M, age 60 to 69, text and app

 17

“I: Okay, is there anything else that you wanted to speak about regarding the messages at all, like the query message style message?

P: No, no. Like I say, I think, to have that, sort of, as a summary of how has the week gone? Have you taken your tablet? Yes. Well done. And, like I say, in a strange sort of way, it’s very motivational.

I: Well that’s good. So, did it motivate you, and how did it motivate you?

P: Well I think you sort of smile when you get the ‘Well done’ and (inaudible 00:10:19) the following week. And I actually did manage to take my tablet every day, on time. So, it just sort of … it’s like an added encouragement.”

Participant 13, M, age 60–69, text

 18

“But yes, it’s an interactive thing isn’t it? So, you’re taking ownership, if you like and dealing with it that way.”

Participant 18, M, age 60 to 69, text and app

 19

“I think the advice part is like kind of key, but also I think, even though it's text message and it limits you to characters, but I think giving succinct points, people are more likely to read them, so maybe on the advice have one topic a week and every day, come up with a different aspect of that topic”

Participant 5, F, age 50–59, text

Participant ID, age, and tested delivery mode

 20

P: Well, the negative sides makes you think oh god, you know, you start to get a little bit thinking that oh, …. if you see what I mean, but not, you know, but if it’s then positive, you think yes, that’s why I need to take them.

Participant 15, F, age 60–69, text

 21

“I: If you were designing the service, was there anything that you would do differently?

P: Well, the only thing that I could suggest would be, although it might be a bit long-winded, if you’ve got morning medication and evening medication that you would perhaps need, like I’ve said before, be more likely to forget the evening one than the morning one because it’s not in my routine so much. But I didn’t get a message for the evening one, so could possibly need a message for both situations.

I: Okay. And would you want those messages to come through separately at the times you take your medication, or would you want one sort of big text message in the morning reminding you of all the medications that you need to take that day?

P: Yes, it would have to be at different times, I suppose, because if I had a message about the morning one and the evening one in the morning, I’m still likely to forget if I was going to in the evening one. So, you’d need two messages a day and I suppose if you’re going to be taking lots of things at different times that might become a little troublesome, I suppose.”

Participant 22, M, age 60–69, text

 22

“And they have am and pm on them, or lunch time one as well. So, you could do it three times a day because most people it is only three times a day for medication. Morning, lunch time, and evening, isn’t it?”

Participant 6, F, age 50–59, text

 23

“I: So, if the reminder came through at a time where

you couldn’t take your medication, did you just press

no or did you use the snooze button to snooze?

P: To be honest, on the app?

I: Yes, on the app?

P: I didn’t know there was one. I never saw that.”

Participant 18, M, age 60 to 69, text and app

 24

“I think help-wise, like a how to maybe, because it’s obviously complicated, a how to guide maybe, that could probably help.”

Participant 18, M, age 60 to 69, text and app

 25

“I didn’t really understand, like looking at this (feedback on behaviour) tab and bits and pieces like that …”

Participant 18, M, age 60 to 69, text and app

 26

“I: Do you wish that we maybe used a bar chart, maybe something more visual or was it okay for you?

P: No. well, everybody is different, aren’t they? Some people prefer, some people learn by visualise, look at it, other people like the colours, like the graphs, other people prefer data as it’s written down.”

Participant 18, M, age 60 to 69, text and app

 27

“P: Probably because, I mean I much easier to just do it on a daily basis becomes sometimes you can be forgetful, unless you write it down, I don’t know. Maybe it might make people anxious about their memory and stuff like that, I don’t know. As much as it has a clinical purpose, why do you need to ask them at the end of the week when it’s just better to ask them every day since their short-term memory is probably much more reliable?

I: Yes, that’s true. So, you would suggest asking, having that query message sent every day instead of once at the end of the week?

P: Yes.”

Participant 14, F, age 60–69, text

 28

“P: I’d probably put a bit less advice in, it might get a bit boring after a while, it’s okay the first week they were all different, I’m sure that if that goes on for months and months and months you’d have to repeat some of them quite regularly.

I: So, less frequent advice messages?

P: All I really would need is a reminder.

I: So, the reminder every day and how often would you have the advice message come through?

P: Probably once a week would be good.”

Participant 11, M, age 70–79, text

 29

“The advice. Not the one reminding you to take your medication, the other one after that. Maybe once or twice a week would be alright, to put something like that out. But getting that every day, seemed to be a little bit too much really…. No. I just think, at my stage, to keep getting advice messages like that, it would lose the point of it, it would lose its impact then ... I just think if it was less frequent, then maybe it would have more of an impact.”

Participant 7, M, age 70–79, text

 30

“What I don’t have any problem with is somebody who comes up front and says this app is going to do and it’s going to watch where you go because, because, because. So, yes, I have concerns, but as you’ve explained that, I have no concerns at all because you’ve been upfront about it.”

Participant 9, M, age 60–69, text and app

31

“I: Okay, so is it that NHS name or that label of the NHS that makes you think (it's secure)?

P: I think it would be the label.

I: So, the labelling of the NHS makes you feel a lot safer with the data?

P: Yes.

I: Okay, similar too, would you feel the same if it was the University of Cambridge logo instead of the NHS?

P: I don’t see why not. I don’t see it being a problem, because I mean you’re with them now and we’re discussing it aren’t we, so I don’t think that would be a problem. It might be for some people.”

Participant 15, F, age 60–69, text

 32

“I personally think, because I’m 70 next year, but in my head, I’m only 50, if you know what I mean. But a lot of people who are my age are forgetful. So, if you’re leading a busy life, I would say at least six weeks, and I’m in week three, but because I get up early in the morning and everything, I’m busy doing things, I tend to forget if I’m sitting in front of the television or something. So, yes, I think six weeks would be a good routine because as I said, I’ve done it in three where I’ve been, oh god, I must take my tablets, it’s eight o’clock. So, I personally think perhaps six weeks would make them more aware that they should be doing this, and that would built a routine.”

Participant 15, F, age 60–69, text

 33

“P: So, you don’t feel as if actually they do take care with what’s happening. It sounds very negative, I don’t mean it quite like that, but I think it’s just a question that they probably would feel worthwhile and that someone understands that they are taking tablets you see. Because I never see the same doctor.

I: So, do you think that this service could maybe help to counteract some of those feelings of being…?

P: Oh yes, definitely.”

Participant 15, F, age 60–69, text