Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Holden, Richard J.; Campbell, Noll L.; Abebe, Ephrem; Clark, Daniel O.; Ferguson, Denisha; Bodke, Kunal; Boustani, Malaz; Callahan, Christopher M.

doi:10.1016/j.sapharm.2019.02.011

Cited by 51 publications

(49 citation statements)

References 65 publications

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“…We adapted the standard methods in several ways, including accommodating older adult participants. For example, we administered a simplified version of the System Usability Scale (SUS) self-report measure, which we developed specifically for older adults [ 9 , 86 , 87 ]. We built flexibility for breaks during testing, especially given the use of diuretic medications by patients with heart failure.…”

Section: Resultsmentioning

confidence: 99%

Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure

Cornet¹,

Toscos²,

Bolchini³

et al. 2020

JMIR Mhealth Uhealth

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Background User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth. Objective This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth. Methods Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges. Results We identified 12 challenges, 3 about UCD as a whole and 9 across the UCD stages of formative research, design, and evaluation. Challenges included the timing of stakeholder involvement, overcoming designers’ assumptions, adapting methods to end users, and managing heterogeneity among stakeholders. To address these challenges, practical recommendations are provided to UCD researchers and practitioners. Conclusions UCD is a gold standard approach that is increasingly adopted for mHealth projects. Although UCD methods are well-described and easily accessible, practical challenges and strategies for implementing them are underreported. To improve the implementation of UCD for mHealth, we must tell and learn from these traditionally untold stories.

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Section: Resultsmentioning

confidence: 99%

Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure

Cornet¹,

Toscos²,

Bolchini³

et al. 2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Living Labs emphasize the iterative process of experimentation and learning by increasing the understanding of real-life problems [49]. The resulting design changes can, thus, reduce errors and enhance usability and user acceptance, so it is the technology that adapts to the user and not the user who has to adapt to the technology [38,50]. In our opinion, this method allows for a more realistic evaluation of the environmental and holistic factors affecting the user.…”

Section: Discussionmentioning

confidence: 99%

“…This is the threshold established in the scientific literature to demonstrate the correct usability of a product [36]. In addition, all semi-structured interviews must be completed, and any improvements suggested from the analysis of the evaluation instruments should be incorporated into the device [37,38]. After completing this process and incorporating the necessary improvements, the researchers should assess the need for a new evaluation cycle according to the extent of the changes performed.…”

Section: Multi-methods Optimization Cyclesmentioning

confidence: 99%

Rationale and Methods of Evaluation for ACHO, A New Virtual Assistant to Improve Therapeutic Adherence in Rural Elderly Populations: A User-Driven Living Lab

Luengo-Polo

Caballero

Jiménez

et al. 2021

IJERPH

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Low therapeutic adherence is a concern for health professionals as it decreases therapeutic efficiency while increasing costs, especially in elderly populations. To increase therapeutic adherence in elderly populations, the technology applied in the medical devices that are used must be adapted to improve usability. This paper outlines the rationale behind, and methods applied to assess the usability of, ACHO (Assistant on Care and Health Offline), a voice assistant that provides elderly patients with reminders of medical appointments to attend and when they need to take their medication. This work is a descriptive, cross-sectional, observational study, and will include a three-phase (analysis, testing and refinement) multidimensional usability analysis of an initial prototype, in the setting of a user-driven Living Lab, which enables the needs and characteristics of the end users to be identified and incorporated into the prototype with each iteration, in which a multidisciplinary team of researchers and users will participate as co-creators. This methodology will allow us to develop a better prototype, increasing usability and, thus, increasing therapeutic adherence.

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“…Whereas the score calculator in the Med Safe app merely calculated the total number of medications, the Brain Safe app calculated a brain harm risk score, let users simulate the effect on risk of adding or removing anticholinergic medications, showed alternative treatments, and helped users start a conversation with their health care professionals about medication safety. Additional detail on features, design, development, and prior testing are available elsewhere [ 30 , 31 ].…”

Section: Methodsmentioning

confidence: 99%

Going Remote—Demonstration and Evaluation of Remote Technology Delivery and Usability Assessment With Older Adults: Survey Study

Hill¹,

Harrington²,

Adeoye³

et al. 2021

JMIR Mhealth Uhealth

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Background The COVID-19 pandemic necessitated “going remote” with the delivery, support, and assessment of a study intervention targeting older adults enrolled in a clinical trial. While remotely delivering and assessing technology is not new, there are few methods available in the literature that are proven to be effective with diverse populations, and none for older adults specifically. Older adults comprise a diverse population, including in terms of their experience with and access to technology, making this a challenging endeavor. Objective Our objective was to remotely deliver and conduct usability testing for a mobile health (mHealth) technology intervention for older adult participants enrolled in a clinical trial of the technology. This paper describes the methodology used, its successes, and its limitations. Methods We developed a conceptual model for remote operations, called the Framework for Agile and Remote Operations (FAR Ops), that combined the general requirements for spaceflight operations with Agile project management processes to quickly respond to this challenge. Using this framework, we iteratively created care packages that differed in their contents based on participant needs and were sent to study participants to deliver the study intervention—a medication management app—and assess its usability. Usability data were collected using the System Usability Scale (SUS) and a novel usability questionnaire developed to collect more in-depth data. Results In the first 6 months of the project, we successfully delivered 21 care packages. We successfully designed and deployed a minimum viable product in less than 6 weeks, generally maintained a 2-week sprint cycle, and achieved a 40% to 50% return rate for both usability assessment instruments. We hypothesize that lack of engagement due to the pandemic and our use of asynchronous communication channels contributed to the return rate of usability assessments being lower than desired. We also provide general recommendations for performing remote usability testing with diverse populations based on the results of our work, including implementing screen sharing capabilities when possible, and determining participant preference for phone or email communications. Conclusions The FAR Ops model allowed our team to adopt remote operations for our mHealth trial in response to interruptions from the COVID-19 pandemic. This approach can be useful for other research or practice-based projects under similar circumstances or to improve efficiency, cost, effectiveness, and participant diversity in general. In addition to offering a replicable approach, this paper tells the often-untold story of practical challenges faced by mHealth projects and practical strategies used to address them. Trial Registration ClinicalTrials.gov NCT04121858; https://clinicaltrials.gov/ct2/show/NCT04121858

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Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Cited by 51 publications

References 65 publications

Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure

Untold Stories in User-Centered Design of Mobile Health: Practical Challenges and Strategies Learned From the Design and Evaluation of an App for Older Adults With Heart Failure

Rationale and Methods of Evaluation for ACHO, A New Virtual Assistant to Improve Therapeutic Adherence in Rural Elderly Populations: A User-Driven Living Lab

Going Remote—Demonstration and Evaluation of Remote Technology Delivery and Usability Assessment With Older Adults: Survey Study

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