Online pharmacy navigation skills are associated with prospective memory in HIV disease

Abstract

Objective: The increased use of online pharmacy services in the midst of the COVID-19 pandemic provides an important backdrop against which to examine the role of neurocognitive functions in health-related Internet navigation skills among persons with chronic medical conditions, such as HIV disease. Prospective memory (PM) is reliably impaired in HIV disease and is related to laboratory-based measures of medication management capacity in other populations. This study examined whether PM shows veridicality in relationship to online pharmacy navigation skills in persons with HIV disease. Method: Participants included 98 persons with HIV disease age 50 and older who completed the Cambridge Prospective Memory Test (CAMPROMPT) and the Medication-Management Test-Revised (MMT-R) as part of a neuropsychological study. Participants also completed the Test of Online Pharmacy Skills (TOPS), which required them to navigate a simulated, experimenter-controlled online pharmacy to perform several naturalistic tasks (e.g., refill an existing prescription). Results: Lower PM had medium associations with poorer MMT-R and TOPS accuracy scores that were not better explained by other neurocognitive functions. The association between PM and TOPS accuracy was driven by errors of omission and did not vary meaningfully based on whether the intention was cued by time or an event. Conclusions: These data suggest that PM cue detection processes show veridicality with online pharmacy navigation skills. Future studies might examine the benefits of PM-based strategies (e.g., salient prompts) in supporting online health navigation skills in populations that experience clinically impactful PM failures.

Internet navigation skills for financial management: Associations with age, neurocognitive performance, and functional capacity.

“…This interpretation is consistent with previous neuropsychological studies that have found memory to be a key aspect of financial management capacity in clinical and nonclinical populations, including older adults (e.g., Niccolai et al, 2017; Sherod et al, 2009), which likely implies that successful navigation on banking websites involves financial skills in addition to INS. Future studies might examine the contribution of prospective memory (PM), or future remembrance of intended actions, in online financial management skills as previous studies have found PM to be significantly associated with measures of financial management capacity (Pirogovsky et al, 2012) and online health navigation skills (Matchanova et al, 2021) among older adults with chronic health conditions. Future studies also may wish to examine the potential benefits of encoding strategies such as elaboration (e.g., paraphrasing the banking task instructions) or visualization (e.g., imagining completing the banking tasks) in online banking performance.…”

Assessing and predicting everyday function.

“…Concurrent validity for the TOPS has been supported through significant associations between the TOPS score and failures on the Medication Management Test-Revised (Heaton et al, 2004), a well-validated performance-based measure of medication management capacity, in a sample of 98 people with HIV (Matchanova et al, 2021). TOPS scores also are associated with multiple neuropsychological measures, although the Cambridge Prospective Memory Test predicted TOPS performance independent of global cognition, suggesting that prospective memory may be especially relevant for accurate online pharmacy use (Matchanova et al, 2021;Woods et al, 2016).…”

Blood Biomarkers of Neuronal/Axonal and Glial Injury in Human Immunodeficiency Virus-Associated Neurocognitive Disorders

“…The diagnosis of HAND followed the Frascati criteria [25] and was based on age-adjusted scores from either the Cogstate [26] or the Cognition Battery from the NIH Toolbox [27]. The different batteries resulted from an administrative shift during the parent project, described in Matchanova et al [28]. The neuropsychological test data were summarized with the Global Deficit Score (GDS) [29], which converts individual T-scores to deficit scores that range from 0 (T-scores >39) to 5 (T-scores <20).…”