Abstract
Medication adherence—taking medication as prescribed—is critical for successful self-care, especially among older adults. Adherence depends on developing and implementing plans for taking medications. Age-related cognitive declines that affect adherence may be mitigated using external tools that support patient-provider collaboration needed to develop these adherence plans. We tested the effectiveness of structured collaborative medication tools to support better medication planning and adherence practices. Evidence for benefits of collaborative tools has been mixed in terms of their usefulness for medication-scheduling tasks, perhaps because the tools have not been explicitly designed to support patient-provider collaboration. A total of 144 community-dwelling older adults participated in pairs and performed the role of a patient or provider in a simulated patient-provider medication-scheduling task. Each pair worked with a structured (MedTable™ and e-MedTable) or unstructured (Medcard) scheduling tool and completed four problems (2 simple and 2 complex). Performance was measured using the following: problem-solving (medication schedule) accuracy, problem-solving time, solution (schedule) optimality, tool usability, collaborative effectiveness, and subjective workload involved in creating the medication schedules. Participants using structured tools produced more accurate and optimal schedules. They also rated subjective workload as lower and thought that the structured tools were easier to use, reduced subjective workload associated with creating the schedules. There was also suggestive evidence that participants using the structured tools rated more highly the quality of their collaboration. Structured medication-scheduling tools have the potential to improve medication adherence among older adults because they support collaborative planning and reduce the cognitive load involved in creating these adherence plans.
Similar content being viewed by others
References
Apsden P, Wolcott JA, Bootman JL, Croenwett LR (2007) Preventing medication errors. The National Academies Press, Washington
Brooke J (1996) SUS: a ‘quick and dirty’ usabiliy scale. In: Jordan PW, Thomas B, McClelland IL, Weerdmeester B (eds) Usability evaluation in industry. Taylor & Francis, Bristol, PA, pp 189–195
Buerhaus PI, Donelan K, Ulrich BT, Norman L, Dittus R (2006) State of the registered nurse workfore in the United States. Nurs Econ 24(1):6–12
Clark HH, Brennan SE (1991) Grounding in communication. In: Resnick LB, Levine J, Teasley SD (eds) Perspectives on socially shared cognition. APA, Washington, pp 127–149
Convertino G, Mentis HM, Rosson MB, Carroll JM, Slavkovic A, Ganoe CH (2008) Articulating common ground in cooperative work: content and process. Paper presented at the CHI ‘08, In: proceeding of the twenty-sixth annual SIGCHI conference on human factors in computing systems, New York, USA
Cordasco KM, Asch SM, Bell DS, Guterman JJ, Gross-Schulman S, Ramer L et al (2009) A low-literacy medication education tool for safety-net hospital patients. Am J Prev Med 37(6 Suppl. 1):S209–S216
d’Ydewalle G, Luwel K, Brunfaut E (1999) The importance of on-going concurrent activities as a function of age in time- and event-based prospective memory. Eur J Cogn Psychol 11:219–237
Doak C, Doak L, Root J (1996) Teaching patients with low literacy skills. JB Lippincott, Philadelphia
Einstein GO, McDaniel MA (1990) Normal Aging and Prospective Memory. J Exp Psychol Learn Mem Cogn 16(4):717–726
Ekstrom RB, French JW, Harman HH (1976) Manual for the kit of factor-referenced cognitive tests. Educational Testing Service, Princeton
Hart SG, Stavenland LE (1988) Development of NASA-TLX (task load index): results of empirical and theoretical research. In: Hancock P, Meshkati N (eds) Human mental workload. Elsevier, Amsterdam, The Netherlands, pp 139–183
Hutchins E (1995) How a cockpit remembers its speeds. Cogn Sci 19(3):265–288
Keppel G, Wickens T (2007) Design and analysis, 5th edn. Prentice Hall, New York
Klein G, Ross KG, Moon BM, Klein DE, Hoffman RR, Hollnagel E (2003) Macrocognition. IEEE Intell Syst 18(3):81–85
Kripalani S, Robertson R, Love-Ghaffari MH, Henderson LE, Praska J, Strawder A et al (2007) Development of an illustrated medication schedule as a low-literacy patient education tool. Patient Educ Couns 66(3):368–377
Larkin JH, Simon HA (1987) Why a diagram is (sometimes) worth ten thousand words. Cogn Sci 11(1):65–100
Machtinger EL, Wang F, Chen LL, Rodriguez M, Wu S, Schillinger D (2007) A visual medication schedule to improve anticoagulation control: a randomized, controlled trial. Jt Comm J Qual Patient Saf 33(10):625–635
Mead S, Lamson N, Rogers WA (2002) Human factors guidelines for web site usability: health-oriented websites for older adults. In: Morrell RW (ed) Older adults, health information, and the world wide web. Erlbaum, Hillsdale, pp 89–107
Mitchell AA, Kaufman DW, Rosenberg L (2007) Patterns of medication use in the United States, 2006: a report from the Slone survey
Morrow DG, Raquel L, Schriver A, Redenbo S, Rozovski D, Weiss G (2008) External support for collaborative problem solving in a simulated provider/patient medication. Sched Task 14(3):288–297
Newell A, Simon HA (1972) Human problem solving. Prentice-Hall, Englewood Cliffs
Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353(5):487–497
Paasche-Orlow MK, Schillinger D, Greene SM, Wagner EH (2006) How health care systems can begin to address the challenge of limited literacy. J Gen Intern Med 21(8):884–887
Park DC (2000) The basic mechanisms accounting for age-related decline in cognitive function. In: Park DC, Schwarz N (eds) Cognitive aging: a primer. Psychology Press, Philadelphia, pp 3–21
Park DC, Jones TR (1997) Medication adherence and aging. In: Fisk AD, Rogers WA (eds) Handbook of human factors and the older adult. Academic Press, San Diego, pp 257–288
Park DC, Morrell RW, Frieske D, Kincaid D (1992) Medication adherence behaviors in older adults: effects of external cognitive supports. Psychol Aging 7(2):252–256
Ryan EB, Meredith SD, MacLean MJ, Orange JB (1995) Changing the way we talk with elders: promoting health using the communication enhancement model. Int J Aging Hum Dev 41(2):89–107
Salthouse TA (1991) Mediation of adult age differences in cognition by reductions in working memory and speed of processing. Psychol Sci 2(3):179–183
Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ (2006) Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption. J Am Med Informat Assoc 13:121–126
Tarn DM, Heritage J, Paterniti DA, Hays RD, Kravitz RL, Wenger NS (2006) Physician communication when prescribing new medications. Arch Intern Med 166(17):1855–1862
Waicekauskas K, Kannampallil TG, Kopren K, Tan P-H, Fu W-T, Morrow DG (2010) Collaborative tools in a simulated patient-provider medication scheduling task. Paper presented at the proceedings of the human factors and ergonomics society
Wolf MS, Curtis LM, Waite K, Bailey SC, Hedlund LM, Davis T et al (2011) Helping patients simplify and safely use complex prescription regimens. Arch Intern Med 171(4):300–305
Zhang J, Norman DA (1994) Representations in distributed cognitive tasks. Cogn Sci A Multidiscip J 18(1):87–122
Acknowledgments
We are grateful for the support from the UIUC Research Board and the National Institute of Nursing Research (R01 NR011300-01A1). We also thank Laura D’Andrea and Shreyans Ranka for their help in running the experiments. This study is part of the Kevin Waicekauskas’s Masters thesis completed at the University of Illinois, Urbana-Champaign. Partial results were presented at the 54th Annual Meeting of the Human Factors Society (Waicekauskas et al. 2010). This study was conducted when the first author was a visiting researcher at University of Illinois, Urbana-Champaign.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Kannampallil, T.G., Waicekauskas, K., Morrow, D.G. et al. External tools for collaborative medication scheduling. Cogn Tech Work 15, 121–131 (2013). https://doi.org/10.1007/s10111-011-0190-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10111-011-0190-7