Patel Tejal, Ivo Jessica, McDougall Aidan, Lee Catherine, Chang Feng, Bauer Jillian, Pritchard Sarah
University of Waterloo School of Pharmacy.
Centre for Family Medicine Family Health Team, Kitchener.
Can Pharm J (Ott). 2022 Feb 10;155(2):119-127. doi: 10.1177/17151635221074977. eCollection 2022 Mar-Apr.
BACKGROUND/OBJECTIVES: The ability to manage medications independently may be affected in older adults due to physical and cognitive limitations. Numerous electronic medication adherence products (eMAPs) are available to aid medication management. Unfortunately, there are no available guidelines to support clinicians in recommending eMAPs. The objective of this study was to create and validate a clinician tool to guide use of eMAPs.
Pharmacists who previously tested the usability of the eMAPs participated in a focus group to provide feedback on 5 metrics of the clinician guide: unassisted task completion, efficiency, usability, workload and an overall eMAP score. Participants were asked semistructured questions on how they would use the tool to inform recommendations of medication aids to patients. The discussions were audio-recorded and transcribed verbatim and qualitatively analyzed. The clinician guide was modified to reflect feedback.
Five pharmacists (80% female, mean years of practice: 15.8) participated in the focus group. The clinician guide was modified by removing 2 metrics and adding an additional 8 metrics: maximum number of alarms, number of days the product can accommodate for based on a daily dosing regimen, price, monthly subscription, portability, locking feature, average time to set the device and number of steps required to set the device. The definition and calculation for unassisted task completion were modified. Additional instructions and specific patient case examples were also included in the final clinician guide.
Since significant variability exists between eMAPs, it is imperative to have a tool for frontline clinicians to use when appropriately recommending the use of these products for medication management in older adults.
背景/目的：由于身体和认知方面的限制，老年人独立管理药物的能力可能会受到影响。有许多电子药物依从性产品（eMAPs）可用于辅助药物管理。不幸的是，目前尚无可用的指南来支持临床医生推荐eMAPs。本研究的目的是创建并验证一种临床医生工具，以指导eMAPs的使用。
之前测试过eMAPs可用性的药剂师参加了一个焦点小组，以提供关于临床医生指南5个指标的反馈：无辅助任务完成情况、效率、可用性、工作量和总体eMAP评分。参与者被问及一些半结构化问题，关于他们将如何使用该工具来为患者提供药物辅助建议。讨论内容进行了录音，并逐字转录和定性分析。根据反馈对临床医生指南进行了修改。
五名药剂师（80%为女性，平均从业年限：15.8年）参加了焦点小组。通过删除2个指标并增加另外8个指标对临床医生指南进行了修改：最大警报次数、产品根据每日给药方案可容纳的天数、价格、月订阅费、便携性、锁定功能、设置设备的平均时间以及设置设备所需的步骤数。修改了无辅助任务完成情况的定义和计算方法。最终的临床医生指南中还包括了额外的说明和具体的患者案例。
由于eMAPs之间存在显著差异，因此必须有一个工具供一线临床医生在为老年人药物管理适当推荐使用这些产品时使用。
