scholarly journals Understanding Older Adults Motivations and Preferences for a Medication Adherence App

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 995-995
Author(s):  
Olivia Kupiec ◽  
Maurita Harris ◽  
Wendy Rogers
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Extrinsic Motivation ◽  
Structured Interview ◽  
Motivation Factors ◽  
Five Factors ◽  
Behavior Change Technique ◽  
Regulation Compliance ◽  
Perceived Choice ◽  
Medication Reminder

Abstract As the percentage of older adults with hypertension continues to increase, medication adherence remains low. However, medication adherence can potentially be improved through the use of medication reminder apps. Medication reminder apps contain numerous features that enable older adults to remember to take their medication, such as providing alerts to take their medication, reminding them when to refill their prescription, and more. Despite being aware of these apps, many older adults lack the motivation needed to use them continuously. We recruited 9 participants (60 years or older) who currently take medication for a chronic condition. Using a mixed-methods approach, we gathered quantitative survey data using the TechSAge Demographic Background, Motivation, and Behavior Change Technique Questionnaires). Qualitative data were gathered through a semi-structured interview that asked questions about general motivations and preferences in addition to engaging participants in co-designing a medication adherence app. Results from the interview were analyzed through a thematic analysis that identified comprehension and preferences of older adults in medication reminder app usage. We tested five different intrinsic motivation factors, and results indicate older adults are most motivated intrinsically due to perceived choice, perceived competence, value/usefulness, effort/importance, and pressure/tension. We also tested five factors of extrinsic motivation, and results indicate older adults are most motivated extrinsically due to introjected regulation, reward-driven, external regulation, compliance, and identification. These data provide insights to guide the design of medication reminder apps to support older adults in the self-management of their chronic conditions.

Exploring Older Adults’ Internalizations And Misconceptions Regarding Antihypertensive Medication Management

2021 ◽  
Vol 10 (1) ◽  
pp. 304-308
Author(s):  
Kenneth A. Blocker ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Medication Management ◽  
Illness Representation ◽  
Effective Management ◽  
Structured Interviews ◽  
Antihypertensive Medications ◽  
Hypertension Knowledge ◽  
Management Behaviors

Hypertension, or high blood pressure, is an asymptomatic cardiovascular condition common with increasing age that must be controlled with proper management behaviors, such as adherence to prescribed antihypertensive medications. Unfortunately, older adults may struggle with consistent and effective management of this medication specifically and the disease generally, which can lead to poorer health outcomes. The goal of the study was to investigate older adults’ antihypertensive medication management using the Illness Representation Model as a lens to identify potential misconceptions that may contribute to medication management. We conducted semi-structured interviews with 40 older adults regarding management routines, hypertension knowledge, perceived nonadherence contributors, and perspectives related to their illness. We identified numerous misconceptions regarding hypertension knowledge, disease severity, as well as perceived adherence performance that may contribute to challenges older adults face with maintaining antihypertensive medication adherence. Moreover, these findings inform the need for and design of effective educational tools for improving antihypertensive medication adherence.

Medication Adherence: Expanding the Conceptual Framework

2021 ◽  
Author(s):  
Marie Krousel-Wood ◽  
Leslie S Craig ◽  
Erin Peacock ◽  
Emily Zlotnick ◽  
Samantha O’Connell ◽  
...  
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Conceptual Framework ◽  
Clinical Outcomes ◽  
Implicit Attitudes ◽  
Explanatory Power ◽  
Population Level ◽  
Time Preferences ◽  
Adherence Behavior ◽  
Individual Level

Abstract Interventions targeting traditional barriers to antihypertensive medication adherence (AHMA) have been developed and evaluated, with evidence of modest improvements in adherence. Translation of these interventions into population-level improvements in adherence and clinical outcomes among older adults remains suboptimal. From the Cohort Study of Medication Adherence among Older adults (CoSMO), we evaluated traditional barriers to AHMA among older adults with established hypertension (N=1544; mean age=76.2 years, 59.5% women, 27.9% Black, 24.1% and 38.9% low adherence by proportion of days covered (i.e., PDC<0.80) and the 4-item Krousel-Wood Medication Adherence Scale (i.e., K-Wood-MAS-4≥1), respectively), finding that they explained 6.4% and 14.8% of variance in pharmacy refill and self-reported adherence, respectively. Persistent low adherence rates, coupled with low explanatory power of traditional barriers, suggest that other factors warrant attention. Prior research has investigated explicit attitudes toward medications as a driver of adherence; the roles of implicit attitudes and time preferences (e.g., immediate versus delayed gratification) as mechanisms underlying adherence behavior are emerging. Similarly, while associations of individual-level social determinants of health (SDOH) and medication adherence are well-reported, there is growing evidence about structural SDOH and specific pathways of effect. Building on published conceptual models and recent evidence, we propose an expanded conceptual framework that incorporates implicit attitudes, time preferences and structural SDOH, as emerging determinants that may explain additional variation in objectively and subjectively measured adherence. This model provides guidance for design, implementation and assessment of interventions targeting sustained improvement in implementation medication adherence and clinical outcomes among older women and men with hypertension.

scholarly journals Cohort Study of Medication Adherence in Older Adults (CoSMO): Extended Effects of Hurricane Katrina on Medication Adherence Among Older Adults

2008 ◽  
Vol 336 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Tareq Islam ◽  
Paul Muntner ◽  
Larry S. Webber ◽  
Don E. Morisky ◽  
Marie A. Krousel-Wood
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Medication Adherence ◽  
Hurricane Katrina

Usability Evaluation of Telepresence Interfaces for Older Adults

2021 ◽  
Vol 65 (1) ◽  
pp. 591-595
Author(s):  
Xian Wu ◽  
Jenay M. Beer
Keyword(s):  
Older Adults ◽  
User Interfaces ◽  
Usability Testing ◽  
Aging Population ◽  
Structured Interview ◽  
Usability Evaluation ◽  
Design Guidelines ◽  
Color Contrast ◽  
Common Features ◽  
Age Related

Telepresence has the potential to assist older adults to stay socially connected and to access telehealth. Telepresence was initially created for office use, thus the usability of telepresence for older adults remains unknown and there is a lack of design recommendations, particularly those with an emphasis on users’ age-related needs and limitations. To bridge the gap, this study assessed two telepresence user interfaces (UIs). One UI was designed to mimic common features founds in commercially available telepresence systems. Another UI was designed based on design guidelines for older adults. Each UI was integrated to a virtual driving environment created via Unity. To assess the usability of both UIs, thirty older adults participated in usability testing. Questionnaires and semi-structured interview were administered following each UI test sessions. Results of this study provide insight on what usability features are critical for the aging population to use telepresence, such as high color contrast, automated controls, and consistent icons.

Abstract P347: Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence among Older Adults (CoSMO)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Elizabeth W Holt ◽  
Cara Joyce ◽  
Adriana Dornelles ◽  
Donald E Morisky ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Administrative Databases ◽  
Medication Cost ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Men And Women ◽  
Factors Associated

Objectives: We assessed whether socio-demographic, clinical, health care system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores among older men and women. Methods: We conducted a cross-sectional analysis using baseline data from the Cohort Study of Medication Adherence in Older Adults (CoSMO, n=2,194). Low antihypertensive medication adherence was defined as a score <6 on the 8-item Morisky Medication Adherence Scale. Risk factors for low adherence were collected using telephone surveys and administrative databases. Results: The prevalence of low medication adherence scores did not differ by sex [15.0% (193 of 1,283) in women and 13.1% (119 of 911) in men p=0.208]. In sex-specific multivariable models, having issues with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores among both men and women. Factors associated with low adherence scores in men but not women included reduced sexual functioning (OR = 2.03; 95% CI: 1.31, 3.16 for men and OR = 1.28; 95% CI: 0.90, 1.82 for women), and BMI ≥25 (OR = 3.23; 95% CI: 1.59, 6.59 for men and 1.23; 95% CI: 0.82, 1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75; 95% CI: 1.16, 2.65 for women and OR =1.16 95% CI: 0.57, 2.34 for men) and depressive symptoms (OR = 2.29; 95% CI: 1.55, 3.38 for women and OR = 0.93; 95% CI: 0.48, 1.80 for men). Conclusion: Factors associated with low antihypertensive medication adherence scores differed by sex. Interventions designed to improve adherence in older adults should be tailored to account for the sex of the target population.

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