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2019-01-16
1
MEDICATION ADHERENCE AIDS FOR USE BY SENIORS
Dr. Tejal Patel School of Pharmacy
University of Waterloo
BACKGROUND• Older adults take 2 - 9 medications per day with complicated medication regimens• Adherence is the extent to which individuals follow prescription recommendations• Non-adherence can result in adverse consequences
2(H a jjar, e t A l., 2 0 0 7 )
FACTORS AFFECTING MEDICATION TAKING
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Physical Ability: Vision,
Hearing, Dexterity
Cognitive Capacity
Caregiver Support
Medication Complexity
and Packaging
Procurement
2019-01-16
2
BACKGROUND • 80 different types of electronic medication aids available for purchase in Canada
•Do not know how effective these products are in improving medication taking by a senior•There are no criteria for a frontline clinician to use to recommend an adherence product
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RESEARCH AIMS1. How user-friendly are some of the medication aids available on the market to seniors?2. How can we enable a clinician to determine which medication aid is best to recommend to a senior who is having trouble managing medications?
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WHAT DID WE DO?1. We developed and tested a tool to enable clinicians to determine
where the problem with medication management is arising from2. We designed a study to test how user-friendly some of the medication
aids are.3. We purchased and tested 22 different products by inviting 39
individuals to test how usable the products were4. We classified the products we found5. We developed a guide
§ User-friendliness§ Workload§ Efficiency§ How completely one was able to complete the tasks
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2019-01-16
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THE DSL-MMC (DOMAIN SPECIFIC LIMITATION IN MEDICATION MANAGEMENT CAPACITY)
•Specific questions/activities that a person may answer or do that allows a pharmacist or physician to determine if there are any problems with managing medications independently• Started with 42 questions; removed 7 and modified 8 after testing
• More testing, actual use with seniors, is being planned
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Limitations to Medication Management Capacity
Physical Abilities
Visi
on
Dex
terit
y
Hea
ring
Cognition
Com
preh
ensio
n
Mem
ory
Exec
utiv
e Fu
nctio
ning
Medication Regimen
Complexity
Dos
ing
Regi
men
Non
-Ora
l Adm
inist
ratio
n
Poly
phar
mac
y
Access and Caregiver
Pres
crip
tion
Refil
l
New
Pre
scrip
tion
Car
egiv
er
PRODUCTS WE TESTEDGMS Med-e-lert Automatic Pill Dispenser
LiveFine Automatic Pill Dispenser and Reminder
MedReady 1700 Automated Medication Dispenser
E-pill Accutab Weekly Pill Dispenser
MedSmart Med-Reminder and Dispensing System*
E-pill MedTime Station Automatic Pill Dispenser with
Tipper*
TimerCap Travel Size
TimerCap Universal Size*
Jones Medication Adherence System*
Reizen Vibrating Pill Box
VitaCarry Advanced Pill Case
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Nishiki Round Pill Box with Alarm
MedGlider System 1 with Talking Reminder*
Patterson Medical TabTime Super 8
MedQ Smart PillBox
E-pill MedGlider Home Medication Management System*
MedCentre System
eNNOVEA Weekly Planner with Advanced Auto
Reminder*
E-pill Multi-Alarm Pocket XL*
6 Grid Pill Storage Case with Alarm
Itzbeen Pocket Doctor*
SOME OF PRODUCTS WE TESTED
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2019-01-16
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CLASSIFICATION OF PRODUCTS
TEJA L PA TEL , PH A RM D
WHO DID WE TEST THE PRODUCTS WITH?
• 39 individuals• 11 pharmacists and occupational therapists• 5 persons who assist seniors with taking their
medications• 23 seniors
• Older adults • Male/Female: 47/53% Mean age: 75 Mean number of medications: 7.5 Use of medication aids: 70%
Pillbox, phone alarms/Fitbit, message board, daily lists, blister package
21% reported they seek help with medications from family members
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•Healthcare professionals Male/Female: 18/82%
Occupation: RPh: 82%; OT: 18%
Mean years of practice: 8.63 (0 – 37 years)
Assisted older adults with medication taking: 82%
•Caregivers Male/Female: 20/80%
Caregiver reported use of medication aid by person cared for: 100%
USER
FRIE
NDLI
NESS
OF T
HE
PROD
UCTS
TEST
ED
1 2
2019-01-16
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WHAT WE FOUND: USABILITY SCORES
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
RA-0
02
PBA-00
1
PBA-00
2
PBA-00
3
PBA-00
4
PBA-00
5
PBA-00
6
PBA-00
7
PBA-00
8
PBA-01
0
PBA-01
1
PBA-01
2
PBA-01
3
Mean PB
A
EPB-O
O2
CC-001
APD-0
01
APD-0
02
APD-0
03
APD-0
04
APD-0
05
APD-0
06
Mean AP
D
SUS
Scor
es
Medication Adherence Products
MEAN SUS SCORES
TEJA L PA TEL , PH A RM D
Acceptable
Marginally
acceptable
Not
acceptable
WHAT WE FOUND
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Unassisted Task Completion
Efficiency (min) SUS(Usability)
NASA-RAW(Workload)
EMAP ScoreDevice Name
GMS Med-e-lert Automatic Pill Dispenser 81% 6% 40.8 67.08 ◑LiveFine Automatic Pill Dispenser and Reminder 70% 5% 46.5 65.21 ◑
MedReady 1700 Automated Medication Dispenser 86% 4% 28.6 72.92 ◔MedSmart Med-Reminder and Dispensing System 67% 5% 41.4 59.63 ◑
e-pill MedTime Station Automatic Pill Dispenser with Tipper 66% 4% 35.1 71.77 ◔TimerCap Travel Size 100% 21% 78.7 29.35 ◕
TimerCap Universal Size 100% 21% 52.9 43.54 ◑Jones Medication Adherence System 80% 6% 50.6 48.63 ◑
Reizen Vibrating Pill Box 78% 7% 50.7 50.28 ◔VitaCarry Advanced Pill Case 88% 8% 52.8 46.11 ◑
Nishiki Round Pill Box with Alarm 82% 7% 46.9 56.48 ◔MedGlider System 1 with Talking Reminder 95% 7% 57.2 45.75 ◑
Patterson Medical TabTime Super 8 81% 10% 57.9 35.65 ◕100-Hour Pill Reminder 96% 12% 55.8 49.35 ◕
MedQ Smart PillBox 85% 9% 64.6 42.17 ◑e-pill MedGlider Home Medication Management System 90% 12% 71.7 28.43 ●
MedCentre System 72% 6% 56.6 52.19 ◑eNNOVEA Weekly Planner with Advanced Auto Reminder 88% 8% 78.1 28.65 ◕
e-pill Multi-Alarm Pocket XL 78% 11% 51.6 45.65 ◑6 Grid Pill Storage Case with Alarm 79% 7% 34.8 65.1 ◔
Itzbeen Pocket Doctor 68% 6% 35 68.33 ◑*e-pill Accutab Weekly Pill Dispenser 82% 20% 63.2 41.02 ◕
QUESTIONS FOR DISCUSSION1. What problems, if any, do you face with
taking your medications?2. How have you solved these problems?3. What are your thoughts about the research
we are doing?4. Do you have any suggestions?
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2019-01-16
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INTERESTED IN PARTICIPATING?
Contact:Tejal Patel, PharmDAssistant Clinical ProfessorUniversity of Waterloo School of PharmacyEmail: t5patel@uwaterloo.caPhone: 519-888-4567 x 21337
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EMAPS TEAM
Jessica Ivo Aidan McDougall Sadaf Faisal Jillian Bauer
Sarah Pritchard Feng Cheng Maheen Farooqi
TEJA L PA TEL , PH A RM D
FUNDERS
RBC Research Fellowship
TEJA L PA TEL , PH A RM D
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