Development of a clinician guide for electronic medication adherence products in older adults

Abstract

Background/objectives: The ability to manage medications independently may be affected in older adults due to physical and cognitive limitations. Numerous electronic medication adherence products (eMAPs) are available to aid medication management. Unfortunately, there are no available guidelines to support clinicians in recommending eMAPs. The objective of this study was to create and validate a clinician tool to guide use of eMAPs. Methods: Pharmacists who previously tested the usability of the eMAPs participated in a focus group to provide feedback on 5 metrics of the clinician guide: unassisted task completion, efficiency, usability, workload and an overall eMAP score. Participants were asked semistructured questions on how they would use the tool to inform recommendations of medication aids to patients. The discussions were audio-recorded and transcribed verbatim and qualitatively analyzed. The clinician guide was modified to reflect feedback. Results: Five pharmacists (80% female, mean years of practice: 15.8) participated in the focus group. The clinician guide was modified by removing 2 metrics and adding an additional 8 metrics: maximum number of alarms, number of days the product can accommodate for based on a daily dosing regimen, price, monthly subscription, portability, locking feature, average time to set the device and number of steps required to set the device. The definition and calculation for unassisted task completion were modified. Additional instructions and specific patient case examples were also included in the final clinician guide. Conclusion: Since significant variability exists between eMAPs, it is imperative to have a tool for frontline clinicians to use when appropriately recommending the use of these products for medication management in older adults.

Tools to measure barriers to medication management capacity in older adults: a scoping review

“…Even though its primary purpose may differ, the framework allowed us to categorize the diverse barriers impacting older adults' medication self-management in a comprehensive manner as physical, cognitive, sensory, and motivational barriers. In addition to these barriers, we aimed to capture the broader contextual factors, including environmental factors such as social support and home environment (e.g., counter space, adequate lighting), that may influence medication-taking among older adults [ 18 – 20 ].…”

“…Motivational challenges that older adults encounter with medication self-management at home include inadequate knowledge about medications and the use of adherence technologies (health literacy and technology literacy), low self-efficacy, lack of confidence in taking medications properly, and integration of medication management during daily activities [ 12 ]. Additionally, research suggests that feedback from care partners and the environment in the home can impact the ability of older adults to self-administer medication [ 18 , 19 ]. Therefore, when assessing various barriers to medication-taking, it is important to take into account a variety of environmental factors, including social factors such as support from family and caregivers and home environment [ 19 , 20 ].…”