Designing for Understanding: Helping Older Adults Understand Over-the-Counter Medication Information

This research is motivated by some of the challenges faced by the healthcare community in communicating health information to the public and the potential for user-centered technology design to address some of these limitations. Each year, thousands die or are injured due to adverse-drug events due to both prescription and over-the-counter medications. The integration of technology has improved the incidence rate for adverse-drug events due to prescription medications. Similarly, personal health records and other consumer-based health applications have been shown to be beneficial for helping individuals manage their health. Despite this growing body of research, little to no research has been conducted to gauge the possible effectiveness of technology created through a user-centered design process to assist consumers in understanding similar events due to over-the-counter medications. This research explores the implications for the design of interactive technology to help older adults understand the possible risk of an adverse drug events resulting from taking over-the-counter (OTC) medications. A user-centered design process was employed, leveraging various techniques to design technology to assist older adults with over-the-counter medication information. The three studies conducted for this research are part of an Exploratory Mixed-Methods Study, designed to identify current practices and challenges, identify opportunities for technology integration, and to examine the usability and effectiveness of the resultant technological artifacts for assisting older adults with over-the-counter medication information. Data collection included semi-structure interviews, surveys, questionnaires, and observations. Results from each study suggest that the technologies evaluated are useful for assisting older adults with over-the-counter medication information. Design recommendations identified throughout each phase are presented to provide insight on the technology features found useful and not so useful by older adults throughout the process of this research

A Technology Solution to Over the Counter Drug Issues

Reading and comprehending the drug packaging information to guide the selection of an appropriate over-the-counter (OTC) drug is a common challenge given concerns of abuse and misuse, addiction, overmedication, and inability to select the drugs in cases where the guidance of a medical professional is not available. This research reviews data on OTC usage in the United States, reviews the process followed by the Food and Drug Administration (FDA) in the transition of drugs from prescription to nonprescription status, and highlights some risks and benefits of OTC medication. It reviews issues in OTC medication, including decision-making in selecting OTC medication, shows a relationship between health literacy and effective use of OTC medication, and covers readability and comprehensibility of the drug label as a concern in OTC drug acquisition and usage. It also reviews some studies on technology approaches in decision-making that supports the selection of OTC medication. The research proposes a technology artifact in the form of a mobile application that consumers would use to guide the selection of a drug by augmenting the drug package information with questions that a pharmacist would ask a customer looking for OTC medication. It also investigates whether the facts of medicine, as presented to a customer, cause information overload to an extent that hampers the selection of a drug, and whether the methods of information presentation differ in terms of knowledge retention, information overload, and perceived usability. The research also evaluates different multimedia methodologies in how they aid the understanding of drug label information to support the selection of an appropriate OTC drug. The study found greater knowledge retention and less information overload on users using the audio-based and video-based mobile apps than those who used text-based apps

Development of an ecological momentary assessment of fatigue after ABI using sequential exploratory design

Background: It is estimated that between 21 -77% people with acquired brain injury (ABI) experience problematic and persistent fatigue. Many struggle to resume their previous levels of activity and participation. Yet the relationship between fatigue and participation is unclear. Current approaches to assessing the impact of fatigue on participation fail to capture the variability of fatigue experiences or to evaluate the efficacy of fatigue interventions. Aim: to develop and evaluate a smartphone ecological momentary assessment (smart EMA) of the impact of fatigue on participation in the context of daily situational factors. Methods: A user- centred design approach guided the development of the smart EMA app and was underpinned by the biopsychosocial approach to disability. The concepts underpinning the app were generated through a systematic review of participation after stroke and narrative reviews of participation after ABI, together with a qualitative descriptive study of fatigue experiences after ABI. Interviews were conducted with people with ABI and the transcripts were analysed using the Frameworks method. Initial prototypes of the smart EMA were developed collaboratively with app developers, and people with ABI. The EMA consisted of self -reports of activity, energy and a psychomotor vigilance test. The app was evaluated using an iterative user-centred approach with Occupational Therapists and people with ABI, through talk aloud interviews, field testing, qualitative interviews and the system usability scale. Results: The systematic review of 82 studies investigating participation outcomes after stroke revealed multiple associations between biopsychosocial factors and participation but fatigue was infrequently investigated. The narrative reviews revealed conflicting evidence of the interplay between fatigue and participation and the need for ecological momentary assessments (EMA) of fatigue was established. 16 people with ABI were recruited to the qualitative study. Four themes were derived through analysis of qualitative interviews: experiencing fatigue in the context of everyday activities, struggling to make sense of fatigue, coping with fatigue, adjusting social participation in the context of fatigue. A model was developed proposing that the impact of fatigue on participation is mediated by coping strategies. The app was positively rated by 7 study participants with ABI, with a mean S.U.S. score of 86. 233 EMA surveys were completed during field testing. Key usability problems were related to the method of alerting participants to complete a survey. Visual inspection of the EMA data suggested within-person variation in temporal patterns of energy, fatigue, and activity, as well as individual differences in fatigue-activity interactions. A short PVT was found to be feasible as an objective indicator of fatigue. Conclusions: these studies suggest coping and self-efficacy as intervention targets for mitigating the impact of fatigue on daily life. A smart EMA app to monitor fatigue and activity in ABI survivors is feasible, acceptable to users, and provides data about fatigue variability in the context of daily activities and environments. As such, the app has potential to ground the choice of selfmanagement strategies in empirical evidence