JMIR Publications

ABSTRACT

Background:

Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people’s independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes, and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of the health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their care. It is also a challenge to perform adequate health assessment and appropriate communication between health care professionals.

Objective:

The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information sharing among care providers and care receivers in order to support and promote medication self-management among older people.

Methods:

The authors used a participatory design (PD) approach for this mixed-method project, which was divided into four phases: Phase I, Conceptualization, consisted of the conceptualization of a system to support medication self- management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consisted of building and bringing together the conceptualized systems from phase I. Phases III (pilot study) and IV (a full-scale study) are described briefly.

Results:

Our participants in phase I were people who were involved in some way in the care of older adults, and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The system will also encourage information sharing between care providers and care receivers. The first is the concept of the Intelligent Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason and act in response to individual needs, preferences and behaviors as these change over time. The second concept is the MedOP system, a system that would be supported by the IAFH, and which consists of three related components: one that assess health behaviors, another that communicates health data, and a third that promotes medication self-management.

Conclusions:

The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the participants, we identified two main concepts that could comprise a system for health assessment, communication and medication self- management: the Intelligent Friendly Home (IAFH), and the MedOP system. These concepts will be tested in this study to determine whether they can facilitate and promote medication self-management in older people.