Accepted for/Published in: JMIR Aging
Date Submitted: Nov 24, 2025
Open Peer Review Period: Nov 24, 2025 - Jan 19, 2026
Date Accepted: Jun 4, 2026
(closed for review but you can still tweet)
Performance-Based Usability of Medication Adherence Technologies Among Older Adults With Diverse Capabilities: A Quantitative Study
ABSTRACT
Background:
Medication adherence technologies (MATs) offer innovative solutions to support older adults in managing complex medication regimens, yet usability challenges can prevent their successful use. Older adults often face cognitive, physical, sensory, motivational, and environmental barriers, which can influence how they interact with these devices. Therefore, performance-based usability testing is essential for identifying usability issues.
Objective:
To evaluate the performance-based usability and user experience (UX) of 13 MATs among older adults with diverse capabilities.
Methods:
A mixed-methods design was used, with 96 participants aged 60 years and older testing smart and electronic MATs using cognitive walkthroughs and predefined usability tasks. Validated tools, including the Self-Medication Assessment Tool (SMAT), Daily Living Tasks Dependent on Vision (DLTV), Whisper Test, Self-Efficacy for Appropriate Medication Use Scale (SEAMS) , and Martin & Park Environmental Demands (MPED) Questionnaire were used to assess individual barriers. Poisson generalized estimating equation (GEE) was used to determine predictors of task success and error rates.
Results:
A total of 96 participants (mean age 75.1 ± 7.7 years, range 61–95) were included, with 37.5% male and 62.5% female. Poisson generalized estimating equation models identified significant predictors of unassisted task success rate, including cognitive score (p < 0.001), physical score (p < 0.001), vision score (p < 0.001), motivational score (p < 0.001), and lower environmental busyness (p = 0.049). Sex (female) was associated with a 9% lower success rate (p = 0.002). Predictors of total error rate included age (p = 0.011), sex (p = 0.009), physical score (p = 0.032), vision score (p = 0.005), DLTV vision score (p = 0.010), MPED routine score (p = 0.037) and interaction between physical score and sex (p =0.004).
Conclusions:
Device design and user characteristics strongly influence MAT usability. Performance-based evaluations provide actionable findings for user-centered design, guiding manufacturers and healthcare providers toward developing and choosing accessible technologies that could improve medication adherence among older adults. Clinical Trial: NA
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