Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 1, 2020
Date Accepted: Mar 28, 2020
Date Submitted to PubMed: Apr 29, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Usability and workload of electronic medication adherence products: A prospective, mixed methods study
ABSTRACT
Background:
A decreased capacity to self-manage medications results in non-adherence, medication errors and drug-related problems in older adults. Previous research identified 80 electronic medication adherence products (eMAPs) available to assist patients with self-management of medications. Unfortunately, the usability and workload of these products is unknown.
Objective:
To examine the usability and workload of a sample of eMAPs.
Methods:
In a prospective, mixed methods study, a sample of older adults, healthcare professionals and caregivers were recruited to test the usability and workload of 21 eMAPs. Each participant tested 5 eMAPs, one-at-a-time, after which they completed the System Usability Scale (SUS) and NASA-Task Load Index (NASA-TLX), instruments that measure the usability and workload involved in using a product. Higher SUS scores indicate more user-friendliness, while lower NASA-TLX Raw scores indicate less workload when using a product.
Results:
eMAPs required a mean of 12.7 steps (range:5-20) for the appropriate use and took, on average, 15.19 minutes to complete the set-up tasks (range:1–56). Participants were able to complete steps without assistance 54% of the time (range:0-100%). The mean SUS and NASA-TLX Raw scores of eMAPs tested was 52.8 (SD:28.7; range:0–100) and 50.0 (SD:25.7; range:4.2–99.2), respectively, revealing significant variability among the eMAPs tested. The most user-friendly products were found to be TimerCap Travel Size, and eNNOVEA Weekly Planner with Advanced Auto Reminder as compared with MedReady 1700 Automated Medication Dispenser (78.67 +/-15.57, P=.031; 78.13 +/-14.13, P=.049, vs. 28.63 +/-21.24, respectively). Similarly, MedReady (72.92+/-18.69) was found to be significantly more work intensive when compared to TimerCap (29.35+/-20.35; P=.027), e-pill MedGlider Home Medication Management System (28.43+/-20.80, P =020), and eNNOVEA (28.65+/-14.97; P=.031). The e-pill MedTime Station Automatic Pill Dispenser with Tipper (71.77+/-21.98) had significantly more workload than the TimerCap (P=.037), MedGlider (P=.028) and eNNOVEA (P=.043).
Conclusions:
This study demonstrated that variability exists in the usability and workload of different eMAPs among older adults, caregivers and clinicians. With few studies having investigated the usability and workload of eMAPs, no benchmarks exist to compare the usability and workload of eMAPs; however, our study highlights the need to assess the usability and workload of different products marketed to assist with medication-taking and provides guidance to clinicians regarding eMAP recommendations for their patients. Future development of eMAPs should ensure that target populations of patients are able to use these products adequately to improve medication management. Clinical Trial: This trial was not registered.
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