Salgado Teresa M, Fedrigon Alexa, Riccio Omichinski Donna, Meade Michelle A, Farris Karen B
Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, United States.
College of Pharmacy, University of Michigan, Ann Arbor, MI, United States.
JMIR Mhealth Uhealth. 2018 May 23;6(5):e129. doi: 10.2196/mhealth.9527.
Smartphone apps can be a tool to facilitate independent medication management among persons with developmental disabilities. At present, multiple medication management apps exist in the market, but only 1 has been specifically designed for persons with developmental disabilities. Before initiating further app development targeting this population, input from stakeholders including persons with developmental disabilities, caregivers, and professionals regarding the most preferred features should be obtained.
The aim of this study was to identify medication management app features that are suitable to promote independence in the medication management process by young adults with developmental disabilities using a Delphi consensus method.
A compilation of medication management app features was performed by searching the iTunes App Store, United States, in February 2016, using the following terms: adherence, medication, medication management, medication list, and medication reminder. After identifying features within the retrieved apps, a final list of 42 features grouped into 4 modules (medication list, medication reminder, medication administration record, and additional features) was included in a questionnaire for expert consensus rating. A total of 52 experts in developmental disabilities, including persons with developmental disabilities, caregivers, and professionals, were invited to participate in a 3-round Delphi technique. The purpose was to obtain consensus on features that are preferred and suitable to promote independence in the medication management process among persons with developmental disabilities. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively.
A total of 75 responses were received over the 3 Delphi rounds-30 in the first round, 24 in the second round, and 21 in the third round. At the end of the third round, cumulative consensus was achieved for 60% (12/20) items in the medication list module, 100% (3/3) in the medication reminder module, 67% (2/3) in the medication administration record module, and 63% (10/16) in the additional features module. In addition to the medication list, medication reminder, and medication administration record features, experts selected the following top 3 most important additional features: automatic refills through pharmacies; ability to share medication information from the app with providers; and ability to share medication information from the app with family, friends, and caregivers. The top 3 least important features included a link to an official drug information source, privacy settings and password protection, and prescription refill reminders.
Although several mobile apps for medication management exist, few are specifically designed to support persons with developmental disabilities in the complex medication management process. Of the 42 different features assessed, 64% (27/42) achieved consensus for inclusion in a future medication management app. This study provides information on the features of a medication management app that are most important to persons with developmental disabilities, caregivers, and professionals.
智能手机应用程序可以成为促进发育障碍患者进行独立药物管理的工具。目前，市场上存在多种药物管理应用程序，但只有一款是专门为发育障碍患者设计的。在针对这一人群启动进一步的应用程序开发之前，应获取包括发育障碍患者、护理人员和专业人员在内的利益相关者关于最受欢迎功能的意见。
本研究的目的是使用德尔菲共识方法确定适合促进发育障碍青年成年人在药物管理过程中实现独立的药物管理应用程序功能。
2016年2月，通过在美国iTunes应用商店中搜索以下术语来汇编药物管理应用程序功能：依从性、药物、药物管理、药物清单和药物提醒。在确定检索到的应用程序中的功能后，将42个功能的最终列表分为4个模块（药物清单、药物提醒、用药记录和附加功能）纳入问卷进行专家共识评分。共有52名发育障碍领域的专家，包括发育障碍患者、护理人员和专业人员，被邀请参加三轮德尔菲技术。目的是就适合促进发育障碍患者在药物管理过程中实现独立的首选功能达成共识。第一轮、第二轮和第三轮的共识分别定义为≥90%、≥80%和≥75%的一致同意。
在三轮德尔菲调查中，共收到75份回复——第一轮30份，第二轮24份，第三轮21份。在第三轮结束时，药物清单模块中60%（1十二/二十）的项目、药物提醒模块中100%（三/三）的项目、用药记录模块中67%（二/三）的项目以及附加功能模块中63%（十/十六）的项目达成了累积共识。除了药物清单、药物提醒和用药记录功能外，专家们还选出了以下最重要的前三项附加功能：通过药房自动补货；能够将应用程序中的药物信息与提供者共享；能够将应用程序中的药物信息与家人、朋友和护理人员共享。最不重要的三项功能包括指向官方药物信息来源的链接、隐私设置和密码保护以及处方补货提醒。
虽然存在几款用于药物管理的移动应用程序，但很少有专门设计用于支持发育障碍患者进行复杂药物管理过程的。在评估的42个不同功能中，64%（二十七/四十二）达成了纳入未来药物管理应用程序的共识。本研究提供了关于药物管理应用程序功能的信息，这些功能对发育障碍患者、护理人员和专业人员最为重要。
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