Collaborative Tools in a Simulated Patient-Provider Medication Scheduling Task

Abstract

Medication adherence is an essential activity for successful self-care, particularly for older adults who take multiple medications. Adherence depends on understanding how to take medication, which in turn depends on effective communication with providers. Unfortunately, physician and patient communication is often substandard and ineffective. Furthermore, successful adherence is often tied to supporting the patient's prospective memory by integrating medication taking with a daily routine. We have developed a paper-based tool (MedTable) for supporting provider-patient collaborative planning about taking medication, which has improved performance in a simulated medication scheduling task. The tool is used as an external workspace that reduces cognitive demands while also facilitating collaboration in a planning task. In the current study, the MedTable was redesigned and an electronic version was also developed. Both tools were compared to a less structured paper tool similar to medication reconciliation cards used in many health care settings (Medcard). 144 community dwelling older adults (aged 60 and over) participated in pairs in a simulated patient-provider medication scheduling task. Each pair solved four medication scheduling problems (2 simple and 2 complex) using one of the three tools (MedTable, e-MedTable, Medcard). Although all three tools supported highly accurate solutions, the MedTable produced significantly more accurate schedules than the Medcard (there were no tool differences in solution time). Moreover, participants rated workload associated with problem solving as lower for the two structured tools compared to the Medcard. The MedTable was also rated more usable than the non-structured aid. Finally, there was no evidence that older adults had difficulty using the computer-based tool, which suggests that a computer-based tool could be an effective intervention for improving provider-patient collaboration.