Designing complex health interventions using experience-based co-design

This chapter outlines a method to design complex interventions for testing in trials and to improve patient care. This combines patient engagement in the design process (using Experience-based Co-design—EBCD) with theory related to behavior change. Our purpose is to show how good practice from implementation science and service development can be used to design interventions for testing in research studies. Interventions that have been designed and tested with real-world conditions in mind are more likely to meet the needs of stakeholders in general and are potentially more adaptable in subsequent local implementation. We also outline how EBCD can be integrated into an intervention design and evaluation project that is embedded within a multisite research project. To demonstrate how this can be done, we use the example of developing complex interventions underpinned by behavior change theory to increase the safety of medication management. In doing so, we discuss the potential use of EBCD in the context of medication optimization research and offer practical tips about how researchers can adapt this method to develop and evaluate interventions. This chapter also offers pragmatic advice about the skills required to conduct this type of research by effectively including considerations for accommodating local variation and ethical approval.