Dispensador automático de medicação inovador e orientado para o futuro para adultos sénior

The population is getting older due to higher life expectancy and lower birth rates. Medication is becoming a bigger part of older adults’ lives. However, as all people do, it is easy to forget to take medication. This forgetfulness can bring a lot of consequences, specially in older adults. This is because of their more fragile health and the complexities in their medication, resulting in lower quality of life and higher number of hospital visits. Non adherence to medication is cause by 3 main factors: patient factors, medication factors and health care providers factors. These intertwine adding to the complexity of the problem, however they can be fixed. Technological solutions were developed along the years, some academically and some are available in the current market. Nevertheless, as all solution, there is always room for improvement. This document sets out to collect the needs of older adults regarding their medication and review current developed systems, in order to idealize an innovative system capable of meeting the needs of older adults while improving current systems. This took a systematic approach, mixing adequate product development methodologies, linear and more traditional, State-Gate, and cyclical and more innovative, Lean. This resulted in a idealization of a future proof system that tries to tackle the non adherence problem as whole. From this idealization it was possible to develop and build a prototype that demonstrates its main functionalities.A população está a envelhecer devido a um acréscimo na esperança de vida e a um decréscimo nas taxas de natalidade. Assim, a medicação está a tornar-se uma parte cada vez mais prevalente em adultos sénior. No entanto, como acontece com a população em geral, é fácil esquecer-se de tomar a medicação. Este esquecimento pode trazer muitas consequências, especialmente em adultos sénior. Isso se deve à sua saúde fragilizada e às complexidades inerente à sua medicação, resultando numa menor qualidade de vida e um maior número de visitas hospitalares. A não adesão à terapêutica é o resultado de 3 fatores principais: fatores do paciente, fatores da medicação e fatores dos prestadores de cuidados de saúde. Estes entrelaçam-se adicionando à complexidade do problema, porém podem ser corrigidos. Soluções tecnológicas foram desenvolvidas ao longo dos anos, algumas academicamente e outras estão disponíveis no mercado atual. No entanto, como todas as soluções, há sempre margem para melhorias. Este documento recolhe as necessidades dos adultos sérnio, em relação à sua medicação, e revê os sistemas desenvolvidos até ao momento,com o objetivo de idealizar um sistema inovador capaz de reponder às necessidades dos adultos sénior, construindo sobre os sistemas atuais. Para isso tomou-se uma abordagem sistemática, adaptando metodologias adequadas de desenvolvimento de produto, lineares e mais tradicionais, State-Gate, e cíclicas e mais inovadoras, Lean. Isto resultou na idealização de um sistema orientado para o futuro que tenta abordar o problema da não adesão à terapêutica como um todo. A partir desta idealização foi possível desenvolver e construir um protótipo que demonstrasse suas principais funcionalidadesMestrado em Engenharia Mecânic

Health Literacy, Cognitive Impairment, and Medication Adherence in Veterans with Heart Failure

Background: Heart failure (HF) affects 5.8 million people in the United States, costly in terms of patient mortality and morbidity as well as healthcare dollars. One important manifestation of poor HF outcomes is the excessive admission-readmission cycle. Non-adherence to medication is responsible for the majority of HF readmissions. Identification and intervention for key factors contributing to poor medication adherence is critical to improving outcomes. Two such factors prevalent in persons with HF are cognitive impairment (CI) and poor health literacy (HL). There is a paucity of tested interventions designed to improve medication adherence by addressing underlying CI or HL. A recent study tested a pictorial medication sheet to improve medication adherence in veterans with HF and CI, however no information on HL was collected. This new study examines what mediating effects HL may have played in the adherence scores of subjects in the completed study. Study Aims: Aim 1. Describe the level of HL in the study population. Aim 2. Determine the strength and direction of the relationships between reading HL and numeracy HL and selected clinical and demographic variables in the study population. Aim 3. Determine the direct and indirect effects that reading HL and numeracy HL and other key variables (including the intervention) have upon medication adherence in cognitively impaired veteran outpatients with HF based on prior data from an interventional study testing a pictorial medication sheet to improve medication adherence. Study Design A retrospective, correlational, cross-sectional design was employed to analyze HL scores from medical records with data from the completed study using conventional statistics and structural equation modeling. Results: 27 subjects with a mean age of 65.3 years (SD 8.2, range 45-80) had evaluable data. HL was less than adequate in 19% of the sample. HL scores were strongly correlated with cognition. HL did not significantly affect relationships between study covariates (cognition scores, depression, number of medications) and medication adherence. Conclusions and Significance: HL scores were associated with cognitive function scores. More research is needed to evaluate the prevalence and effect of poor HL in veterans with HF upon adherence

Living at home with dementia: a client-centered program for people with dementia and their caregivers

Thesis (O.T.D.)--Boston UniversityThe number of elderly Americans is increasing rapidly, and dementia is prevalent within this population, especially among the growing group of people over the age of 90 (National Institutes of Health, 2011; Plassman, et al., 2007). The majority of elderly people, including many with dementia, report that they would like to stay in their own homes, which is cost effective for the family and community (Keenan, 2010; Alzheimer's Association, 2012). In addition, people with dementia who live at home are happier, safer, and more independent than those who have been placed into another setting (Alzheimer's Society, 2013). However, they present with a variety of health and safety concerns which have an impact on both their own and their caregivers' quality of life (Allan, et al., 2009; Etters, et al., 2007, Gitlin, 2010). Described in this doctoral project is a caregiver- and client-centered program geared towards delaying or even avoiding long-term care placement of people with dementia by helping to increase client tranquility, independence, and safety, therefore decreasing daily challenges and caregiver feelings of burden. Through this intervention, caregivers will be empowered with skills and strategies with which to engage and support their loved one with dementia, as they are educated regarding the following elements: methods for promoting autonomy in self-care; ways of incorporating meaningful activity into the daily routine; methods for increasing home safety; and strategies for challenging behaviors. This program incorporates a personalized approach, the inclusion of meaningful activity, safe and effective strategies for daily tasks, and an introduction to technology aides and adaptive equipment. A thorough review of the literature was completed in order to ascertain the most effective strategies for addressing the problems affecting informal home caregivers. Best practices are incorporated into the group and individual session structure, and included is a detailed information packet for clients with guidance regarding each of the 14 topics included in the program: information about dementia; fall prevention at home; self-care tasks; successful mealtimes; cooking and kitchen safety; medication management; using the telephone/emergency assistance; wandering and getting lost; rummaging, hiding, and hoarding solutions; sleep strategies; meaningful activity; the preferences worksheet; life story books; and useful resources

Hi pill : designing medication packaging to encourage adherence : an exegesis presented in partial fulfilment of the requirements for the degree of Master of Design, Massey University, College of Creative Arts, Wellington, New Zealand

Failure to adhere to dosage time frames with prescribed medications is recognized as a global health problem. The World Health Organization (WHO), notes the level of nonadherence to drugs ranges from 30%-50% in developed countries and is even higher in developing countries (Sabate, Santé, Organisation, WHO, & UNAIDS, 2003). Importantly, the design of pillbox packaging has a positive impact on pill adherence (Zedler, Kakad, Colilla, Murrelle, & Shah, 2011). This research project explores how packaging and communication design of a pill organizer can encourage adherence improving potential health outcomes. To investigate the issue, a human-centered design method was implemented. Through the methods of interviews and observation, users' requirements are explored, and analyzed. This information informed the design of the Hi Pill solution. The design was undertaken in stages, the initial investigation was presented in sketches and 3D models for initial usability testing, screened for development potential and then resolved into five key variations of the resolved design. The optimal solution was developed from these final variations and further tested with end users and stakeholders. The results supported the structural packaging concept integrated with communication design considerations as an effective means of promoting medication adherence with prescribed medication