JMIR Publications

ABSTRACT

Background:

Poor medication adherence among older adults with multiple chronic conditions (MCC) and polypharmacy is a substantial public health concern stemming from a variety of distinct challenges. Prior interventions have largely utilized a “one size fits all” approach, or resource intensive approaches inappropriate for busy primary care clinics.

Objective:

We sought to implement and evaluate the feasibility and acceptability of a portal-based intervention designed to monitor medication adherence challenges among older adults in primary care.

Methods:

We conducted a patient randomized study with a post-test design. Primary care physicians at the participating health center were informed of the study and approval was obtained to contact their patients. Potentially eligible patients were then identified using an electronic health record query and a research coordinator phoned them to confirm eligibility, assess interest, and obtain consent. Randomization occurred immediately following enrollment. Those randomized to PATTERN received a medication adherence assessment in their patient portal accounts two to three days ahead of a scheduled clinic visit. The research coordinator then conducted post-test interviews with participants approximately two weeks after their clinic visit.

Results:

We enrolled 64 participants (n=32 usual care, n=32 intervention). Results revealed most participants self-reported being active users of the patient portal. However, electronic health record data revealed less than half of all intervention participants (47%, n=15/32) completed the adherence assessment and many (75%), including some who completed it, indicated they were unaware they had been asked, via email and a portal message, to complete the assessment.

Conclusions:

The PATTERN intervention has potential for use with older primary care patients experiencing MCC and polypharmacy. Yet, further adaption and/or training is needed to ensure recipients access their patient portal accounts and complete assessments on time. Clinical Trial: The study was registered at ClinicalTrials.Gov, Clinical Trial number NCT05766423.