Medication Management Apps: Usable by Older Adults?

For older adults, managing medications can be a burden and could lead to medication non-adherence. To decrease risks associated with medication non-adherence, healthcare providers may recommend medication reminder apps as an assistive tool. However, these apps are often not designed with consideration of older adults’ needs, capabilities, and limitations. To identify whether available apps are suitable for older adults, we conducted an in-depth cognitive walkthrough and a heuristic evaluation of the most commonly downloaded medication reminder app. Findings revealed three main issues: 1) difficulty in navigation, 2) poor visibility, and 3) a lack of transparency. We also selected the top five downloaded medication reminder apps and categorized user reviews to assess app functionality and usability problems. The results of our analysis provide guidance for app design for older adult users to provide effective tools for managing medications and supporting patient/user health.

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Communicating with the Older Adult Cancer Patient

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0085 ◽

2021 ◽

pp. 678-684

Author(s):

Patricia A. Parker ◽

Smita C. Banerjee ◽

Beatriz Korc-Grodzicki

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Psychological Distress ◽

Cancer Patients ◽

Older Adult ◽

Adult Population ◽

Healthcare Providers ◽

Multiple Morbidity ◽

Older Adult Population

The older adult population continues to increase. Among all known risk factors for developing cancer, the most important is growing old. Thus, caring for older adults with cancer is of increasing importance. This chapter describes important considerations involved in communicating with cancer patients including sensory impairment, cognitive impairment, multiple morbidity, polypharmacy, and psychological distress. It also describes how stereotyping and ageism affect communication with older adults with cancer. Finally, the chapter discusses ways to facilitate communication with older adult cancer patients and their families and provides an example of a training program that was created specifically to enhance communication between healthcare providers and older adult cancer patients and their families.

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Exploration of home care nurse’s experiences in deprescribing of medications: a qualitative descriptive study

BMJ Open ◽

10.1136/bmjopen-2018-025606 ◽

2019 ◽

Vol 9 (5) ◽

pp. e025606 ◽

Cited By ~ 2

Author(s):

Winnie Sun ◽

Farah Tahsin ◽

Caroline Barakat-Haddad ◽

Justin P Turner ◽

Cheryl Reid Haughian ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Medication Management ◽

Informal Caregivers ◽

Healthcare Providers ◽

Learning Needs ◽

Open Communication ◽

Barriers And Enablers ◽

Qualitative Descriptive ◽

Home Care Nurses

ObjectivesThe aim of this study is to explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing.MethodsThis study employed an exploratory qualitative descriptive research design, using scalability assessment from two focus groups with a total of 11 home care nurses in Ontario, Canada. Thematic analysis was used to derive themes about home care nurse’s perspectives about barriers and enablers of deprescribing, as well as learning needs in relation to deprescribing approaches.ResultsHome care nurse’s identified challenges for managing polypharmacy in older adults in home care settings, including a lack of open communication and inconsistent medication reconciliation practices. Additionally, inadequate partnership and ineffective collaboration between interprofessional healthcare providers were identified as major barriers to safe deprescribing. Furthermore, home care nurses highlighted the importance of raising awareness about deprescribing in the community, and they emphasised the need for a consistent and standardised approach in educating healthcare providers, informal caregivers and older adults about the best practices of safe deprescribing.ConclusionTargeted deprescribing approaches are important in home care for optimising medication management and reducing polypharmacy in older adults. Nurses in home care play a vital role in medication management and, therefore, educational programmes must be developed to support their awareness and understanding of deprescribing. Study findings highlighted the need for the future improvement of existing programmes about safer medication management through the development of a supportive and collaborative relationship among the home care team, frail older adults and their informal caregivers.

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INTEREST GROUP SESSION—HEALTH BEHAVIOR CHANGE: USING DATA ABOUT PATIENT CHARACTERISTICS TO IMPROVE FALL PREVENTION

Innovation in Aging ◽

10.1093/geroni/igz038.2091 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S566-S566

Author(s):

Gwen Bergen

Keyword(s):

Older Adults ◽

Older Adult ◽

Fall Prevention ◽

Fall Risk ◽

Healthcare Providers ◽

Patient Characteristics ◽

Health Behavior Change ◽

Clinical Aspects ◽

Evidence Based ◽

Prevention Strategies

Abstract Over one in four U.S. older adults (age 65+) reports falling each year with fall-related medical costs estimated at $50 billion. The American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons recommends that healthcare providers assess and manage their patients’ fall risk. The Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative helps healthcare providers incorporate these guidelines by providing tools on how to screen, assess, and intervene to reduce risk. Evaluations of fall prevention have focused on the clinical process and outcomes. Understanding clinical activities is important in fall prevention but a better understanding of older adult characteristics that increase fall-risk, and attitudes that may affect their adoption of evidence-based interventions could improve the effectiveness of prevention strategies. The five presentations in this session include: 1. Demographic, health and functional characteristics of older adults with increased fall risk. 2. Caregivers of people with chronic conditions or disability as a group with increased fall risk. 3. The most effective and efficient ways of identifying older adults with increased fall risk. 4. Facilitators and barriers to older adults’ adherence to evidence-based fall interventions. 5. Applying knowledge of older adult attitudes to improving an implementation of STEADI-based fall prevention. Multifactorial fall prevention strategies such as STEADI focus on the clinical aspects of fall prevention but their success depends on understanding and incorporating older adult characteristics and attitudes. The information presented in this session can inform fall prevention strategies and improve health.

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AN EXPLORATION OF HOME CARE NURSES’ EXPERIENCES IN DEPRESCRIBING OF MEDICATIONS FOR OLDER ADULTS IN THE COMMUNITY

Innovation in Aging ◽

10.1093/geroni/igz038.2607 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S710-S710

Author(s):

Winnie Sun

Keyword(s):

Older Adults ◽

Home Care ◽

Medication Management ◽

Informal Caregivers ◽

Healthcare Providers ◽

Vital Role ◽

Learning Needs ◽

Open Communication ◽

Barriers And Enablers ◽

Home Care Nurses

Abstract The aim of this study is to explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing. This study employed an exploratory qualitative descriptive research design, using scalability assessment from two focus groups with a total of eleven home care nurses in Ontario, Canada. Thematic analysis was used to derive themes about home care nurse’s perspectives about barriers and enablers of deprescribing, as well as learning needs in relation to deprescribing approaches. Home care nurse’s identified challenges for managing polypharmacy in older adults in home care settings, including a lack of open communication and inconsistent medication reconciliation practices. Additionally, inadequate partnership and ineffective collaboration between inter-professional healthcare providers were identified as major barriers to safe deprescribing. Further, home care nurses highlighted the importance of raising awareness about deprescribing in the community, and they emphasized the need for a consistent and standardized approach in educating healthcare providers, informal caregivers, and older adults about the best practices of safe deprescribing. Nurses in home care play a vital role in medication management and, therefore, educational programs must be developed to support their awareness and understanding of deprescribing. Study findings highlighted the need for the future improvement of existing programs about safer medication management through the development of a supportive and collaborative relationship among the home care team, frail older adults and their informal caregivers.

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Medication Management Among Older Adults With Multiple Chronic Conditions: What Role Do Caregivers Play?

Innovation in Aging ◽

10.1093/geroni/igaa057.1394 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 431-432

Author(s):

Rachel O’Conor ◽

Morgan Eifler ◽

Andrea Russell ◽

Lauren Opsasnick ◽

Julia Yoshino Benavente ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Chronic Conditions ◽

Management Practices ◽

Qualitative Interviews ◽

Medication Management ◽

Multiple Chronic Conditions ◽

A Value ◽

Older Adult Caregivers ◽

Constant Comparative Analysis

Abstract Many older adults manage multiple chronic conditions (MCC) that require adherence to complex medication regimens. Few studies have investigated the degree to which caregivers support medication-related behaviors. We conducted semi-structured qualitative interviews with 25 caregivers of older adults with MCC to characterize caregiver medication assistance. Two coders used content and constant comparative analysis to analyze transcripts. The mean age of caregivers was 61 years; the majority were female (68%) and identified as non-white (Black, 52%; Hispanic, 8%). Caregivers were predominantly spouses (n=10), or children (n=11). Older adults were on average 73 years old, managing 5 chronic conditions and prescribed 7 medications. Caregivers acknowledged the importance of medications to the older adult’s health, but their involvement in daily medication management was limited. Some caregivers preferred that the older adult continue these tasks to maintain autonomy, especially when caring for older adults who valued maintaining independence. Caregivers assumed medication responsibilities after older adults experienced sudden changes in health or upon observing non-adherence (e.g. full pill bottles). Older adults with higher medication burden (12+ medicines) adopted inefficient, cumbersome medication management practices; caregivers suggested simplified strategies, but the older adults refused to adopt recommended strategies. To combat resistance from the older adult, caregivers disguised assistance and deployed workaround strategies to monitor medication-taking behaviors. These findings suggest older adults and caregivers share a value of promoting independence of medication management, up until safety is seriously questioned. Additionally, there is a breakdown in communication at the time when older adults may benefit from increased caregiver involvement.

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COMPARISON OF HEURISTIC EVALUATION AND COGNITIVE WALKTHROUGH METHODS IN DOING USABILITY EVALUATION OF MOBILE-BASED DEL EGOV CENTRE HOSPITAL INFORMATION SYSTEM

SEMINASTIKA ◽

10.47002/seminastika.v3i1.244 ◽

2021 ◽

Vol 3 (1) ◽

pp. 99-106

Author(s):

Gracella Tambunan ◽

Lit Malem Ginting

Keyword(s):

Mobile Application ◽

Evaluation Method ◽

Likert Scale ◽

Usability Evaluation ◽

Heuristic Evaluation ◽

Usability Problems ◽

Interactive Product ◽

Cognitive Walkthrough ◽

Centre Hospital ◽

Usability Evaluation Methods

Usability is a factor that indicates the success of an interactive product or system, such as a mobile application. The increasing use of smartphones demands a more accurate and effective usability evaluation method to find usability problems, so that they can be used for product improvement in the development process. This study compares the Cognitive Walkthrough method with Heuristic Evaluation in evaluating the usability of the SIRS Del eGov Center mobile application. Evaluation with these two methods will be carried out by three evaluators who act as experts. Finding problems and recommending improvements from each method will produce an improvement prototype made in the form of a high-fidelity prototype. Each prototype will be tested against ten participants using the Usability Testing method, which will generate scores through the SUS table. From the test scores, the percentage of Likert scale and the success rate of each prototype will be found. The results show that between the two usability evaluation methods, the Heuristic Evaluation method is the more effective method, finds more usability problems, and has a higher Likert scale percentage, which is 66.5%, while Cognitive Walkthrough is 64.75%.

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Exploring the Patient-Provider Relationship in Older Adult Pain Management

Innovation in Aging ◽

10.1093/geroni/igab046.3386 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 945-946

Author(s):

Sophia Sheikh ◽

Natalie Spindle ◽

Jennifer Brailsford ◽

Jason Beneciuk ◽

Monika Patel ◽

...

Keyword(s):

Older Adults ◽

Pain Management ◽

Older Adult ◽

Pain Treatment ◽

Healthcare Providers ◽

Educational Interventions ◽

Structured Interviews ◽

Patient Centered ◽

Study Objective ◽

Management Approaches

Abstract Successful health outcomes in older patients are linked to the quality of the patient-provider relationship. Our study objective was to further understand the role of this relationship specific to pain management through perspectives from older adults and healthcare providers. Semi-structured interviews and focus groups were conducted with 9 older adults and 11 multidisciplinary healthcare providers. Transcripts were analyzed using a thematic analysis. Three main concepts emerged: (1) defining pain management goals — differences in providers and patients’ goals for pain and function, with sub-themes of realistic goal setting and a shift in pain treatment to minimize opioids as a first-line medication; (2) communication — perceived gap in providers communicating and coordinating across disciplines and with patients, with sub-themes of improving positive communication and inconsistent messaging among providers; and (3) therapeutic alliance — all parties feel that developing a relationship is built on consistent trust and open dialogue. Although providers and older adults often expressed similar perspectives, there were several areas of misalignment identified within each concept, representing areas of disconnect within the patient-provider pain management relationship. Our findings indicate providers could benefit from education on improving communication around realistic goals and patient-centered outcomes and incorporation of more holistic pain management approaches when working with older adult patients. Further study should focus on developing educational interventions to address the identified shortcomings.

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Determining the Effectiveness of the Usability Problem Inspector: A Theory-Based Model and Tool for Finding Usability Problems

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1518/hfes.45.3.455.27255 ◽

2003 ◽

Vol 45 (3) ◽

pp. 455-482 ◽

Cited By ~ 21

Author(s):

Terence S. Andre ◽

H. Rex Hartson ◽

Robert C. Williges

Keyword(s):

Interface Design ◽

Cost Effective ◽

Usability Evaluation ◽

Heuristic Evaluation ◽

Evaluation Tool ◽

Stage Of Development ◽

Usability Problems ◽

Usability Problem ◽

Potential Applications ◽

Cognitive Walkthrough

Despite the increased focus on usability and on the processes and methods used to increase usability, a substantial amount of software is unusable and poorly designed. Much of this is attributable to the lack of cost-effective usability evaluation tools that provide an interaction-based framework for identifying problems. We developed the user action framework and a corresponding evaluation tool, the usability problem inspector (UPI), to help organize usability concepts and issues into a knowledge base. We conducted a comprehensive comparison study to determine if our theory-based framework and tool could be effectively used to find important usability problems in an interface design, relative to two other established inspection methods (heuristic evaluation and cognitive walkthrough). Results showed that the UPI scored higher than heuristic evaluation in terms of thoroughness, validity, and effectiveness and was consistent with cognitive walkthrough for these same measures. We also discuss other potential advantages of the UPI over heuristic evaluation and cognitive walkthrough when applied in practice. Potential applications of this work include a cost-effective alternative or supplement to lab-based formative usability evaluation during any stage of development.

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Mobile Health Apps: Improving Usability for Older Adult Users

Ergonomics in Design The Quarterly of Human Factors Applications ◽

10.1177/1064804619840731 ◽

2019 ◽

Vol 27 (4) ◽

pp. 4-13 ◽

Cited By ~ 8

Author(s):

Stephanie A. Morey ◽

Rachel E. Stuck ◽

Amy W. Chong ◽

Laura H. Barg-Walkow ◽

Tracy L. Mitzner ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Mobile Apps ◽

Medication Management ◽

Health Apps ◽

Access To Health ◽

Mobile Health Apps ◽

Potential Benefits ◽

Smartphone Use ◽

Older Populations

With smartphone use among older populations on the rise, older adults have increased access to health-focused mobile apps. Despite their potential benefits for managing health, currently no guidelines exist for designing these apps specifically for older adult users. We evaluated the usability of one medication management app and two congestive heart failure management apps using cognitive walkthroughs, heuristic analysis, and user testing. We identified design issues that may affect usability for older users, including poor navigation, small button sizes, and inadequate data visualizations. We provide guidelines for developers of health apps to facilitate use by older adults.

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FAMILY CAREGIVER CONTRIBUTIONS TO HOME HEALTH FOR OLDER ADULTS: PREDICTORS OF ADEQUATE SUPPORT

Innovation in Aging ◽

10.1093/geroni/igz038.748 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S206-S206

Author(s):

Julia Burgdorf ◽

Judith D Kasper ◽

Jennifer L Wolff

Keyword(s):

Older Adults ◽

Older Adult ◽

Medication Management ◽

Home Health ◽

Community Dwelling ◽

Assessment Data ◽

Caregiver Support ◽

Factors Affecting ◽

Nationally Representative ◽

Community Dwelling Older Adults

Abstract Family caregivers play a crucial role in supporting older adults through home health (HH) episodes; yet no prior research examines factors affecting the adequacy of caregiver support during HH. We use a novel dataset linking nationally-representative survey data with HH assessment data for community-dwelling older adults (n=2,128) to identify older adult characteristics associated with adequate caregiver support in four task categories (Activities of Daily Living, medication management, medical tasks, and safety/oversight) during a subsequent HH episode. Weighted, multivariable logistic regression is used to model the likelihood of adequate caregiver support in each category. Multiple older adult characteristics prior to the HH episode were associated with greater likelihood of adequate caregiver support during HH, including: prior caregiver assistance with mobility, self-care, and health care tasks, living with others, and cognitive impairment. These findings reveal new risk factors for consideration in risk assessment and payment adjustments related to social determinants of health.

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