JMIR Publications

ABSTRACT

Background:

To date, several medication adherence applications have been developed. However, existing applications have been developed without involving relevant stakeholders and were not subjected to mobile health application guidelines. The usability and utility of these applications have also not been tested with end-users.

Objective:

To describe the usability and utility testing of a newly developed medication adherence application (Med Assist) among ambulatory care patients in Malaysia.

Methods:

Med Assist was developed based on the Theory of Planned Behaviour and Nielson’s usability model. Beta testing was conducted from March-May 2016 at a primary care clinic in Kuala Lumpur. Ambulatory care patients who scored ≥40% on the e-Health literacy scale, ≥21 years and taking ≥2 long-term medications were recruited. Two rounds of in-depth interviews were conducted with each participant. The first interview, which was conducted upon participant recruitment, was to assess the usability of Med Assist. Participants were asked to download Med Assist into their phone and to perform two tasks (to register themselves on Med Assist and to enter at least one medication). Participants were encouraged to “concurrently think aloud” when using Med Assist, while non-verbal cues were observed and recorded. The second interview (conducted ≥7 days later after the first interview) was to assess the utility of Med Assist after using the application for approximately one week. This was done using “retrospective probing” based on a topic guide developed on utilities that could improve medication adherence.

Results:

Med Assist (version P4) underwent usability and utility testing. Thirteen participants were recruited (6 males, 7 females) for beta testing. Three themes emerged from the usability testing; whilst three themes emerged from the utility testing. From the usability testing, participants found Med Assist easy to use and user-friendly as they were able to complete the tasks given to them. However, the details required when adding a new medication were found to be confusing despite displaying information in hierarchical order. Participants who were caregivers as well as patients found the multiple user support and pill buddy utility useful. This suggests that Med Assist may improve the medication adherence of patients on multiple long-term medications.

Conclusions:

The usability and utility testing of Med Assist with end-users made Med Assist more patient-centred in ambulatory care. From the usability testing, the overall design and layout of Med Assist was simple and user-friendly enough for participants to navigate through the application and to add a new medication. From the participants’ perspectives, Med Assist was a useful and reliable tool with the potential to improve medication adherence. In addition, utilities such as multiple user support and medication refill reminder encouraged improved medication management.