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 (Hajjar, et Al., 2007) FACTORS AFFECTING MEDICATION TAKING 3 Physical Ability: Vision, Hearing, Dexterity Cognitive Capacity Caregiver Support Medication Complexity and Packaging Procurement
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V2 Medication Adherence Aids for Use by Seniors 1.15 · GMS Med-e-lertAutomatic Pill Dispenser 81% 6% 40.8 67.08 LiveFineAutomatic Pill Dispenser and Reminder 70% 5% 46.5 65.21 MedReady1700
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2019-01-16
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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
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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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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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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%