In 2015 Anna De Simoni was awarded a small CPE grant to organise two workshops in two community centres in London with over 65 years old on daily medications. The topic of discussion was whether they consider technology helpful with their daily medication taking. Her post summarises these conversations, which have informed a successful National Institute of Health Research (NIHR) programme grant application and offer insights to clinicians and policy makers about the potential role of technologies in medicine taking in this patient group.
15 May 2018
Around one tenth of cardiovascular events are associated with poor medication adherence, but some patients could be helped through new technologies to aid them with tablet taking and monitor adherence.
Some technologies include apps that allow patients to receive counselling about medications and reminders to improve and monitor tablet taking. There are also interactive text message reminders for tablet taking. And Ingestible sensor systems (ISSs) are a combination of wearable and ingestible sensors working in conjunction with smartphones, PCs and tablets to detect ingested medication.
However, not much is known on whether over 65s might find it difficult to adopt these technologies, due to ethnic diversity, and age-related physical and mental impairments. These results were published in the Journal of International Medical Research, investigated opinions about available technologies in a focus group of patients aged over 65 taking cardiovascular medications.
In 2015, I was awarded a small CPE grant to organise two workshops in two community centres in London with over 65 years old on daily medications. The topic of discussion was whether they consider technology helpful with their daily medication taking. The workshops were conducted in two East London community centres –Southern Grove Community Centre knitting group, and Bromley-by-Bow Community Centre Healthy Lifestyle group and took place straight after the community activity in the Centre premises, facilitated by Anna De Simoni, a NIHR Academic Clinical Lecturer and a GP.
Over 65s say they would find technology to help them take their medications helpful, but need the technology to be familiar, accessible and easy to use. The over 65s in the study generally valued the opportunity to receive alerts to help with practical aspects of medicine taking, like forgetting and monitoring treatment:
"I mean it's a similar thing with now that hospitals, they text you to remind you about your hospital appointment now."
People familiar with smartphones welcomed an intervention through smartphones. Some participants were not familiar with smartphones, but all used wristwatches and preferred interventions using this technology, such as smartwatches:
". . .watches, if we all had watches. . .If it's simpler to use elderly would appreciate more, it's something that they have on their hand, on their arm. . . It's a continuation of what we're familiar with instead of something that we're not familiar."
Other concerns included potential reduction in face-to-face communication, data security, becoming dependent on technology and worrying about the consequences of technological failures:
"Well I see [technology might cause] lack of communication between professionals and the very elderly. . .., I'm afraid that this is about cost-cutting."
"Technology is useful but you can't depend on it, you never can depend on it."
In clinical consultations about medicine taking, healthcare professionals can explore technologies familiar and easily accessible to patients as a way to ensure good adherence. To this end additionally checking on common concerns, like worries about data security, becoming dependent on technology and consequences of technological failures can be beneficial.
Surprisingly, these findings have highlighted that people over 65 on cardiovascular medications are willing to consider technology to help with practical aspects of their day-to-day medicine taking, such as getting reminder alerts and monitoring doses taken, either themselves or by carers and clinicians.
The CPE greatly helped this study not only by funding the events and the transcription of the discussions, but also with precious advice and suggestions on options to explore for the workshops, contacts for organising the events and how to best engage with participants. The award informed and strengthened the funding bid, which is something I would recommend to colleagues.