A touch screen–enabled “Personal Education Program” was modified to the “next generation” to capture self-medication behaviors of older adults with hypertension and assess related knowledge and self-efficacy. The program analyzes patient-entered information and delivers interactive educational content tailored to the reported behaviors. Summaries of self-reported symptoms, medication use (including frequency/time), drug interactions, and corrective strategies with an illustration of the drug interaction are printed to inform the provider before the primary care visit and for the patient to take home for self-study. After formative research during development and formal diagnostic and verification usability studies with advanced practice nurses and older adults, a beta test was conducted with older adults with hypertension over a 3-month period. Findings from the beta test suggest that older adult user satisfaction was high. Blood pressure declined over the four visits for 82% of the participants. The next generation of the Personal Education Program had a large effect size in increasing knowledge and self-efficacy for avoiding adverse self-medication behaviors. Behavior risk score did not change significantly but was significantly correlated with systolic blood pressure on the fourth visit. The positive results found in this small sample suggest that the next generation of the Personal Education Program could play a central role in facilitating patient-provider communication and medication adherence.
A computer based scale on health care relationships was developed as part of a test of a touch screen Personal Education Program (PEP) designed to increase medication adherence and reduce adverse self-medication behaviors in older adults with hypertension. The 5-item, self-report Relationships with Health Care Provider Scale (RHCPS), initially in paper and pencil format, underwent several iterations to document internal consistency reliability, content and factorial validity, and to assess scale usability in a computer tablet format. Five expert judges rated items, showing both Item Content Validity and Scale Content Validity Indices having high ratings of relevance across all judges. Principal components analysis extracted one factor with an eigenvalue greater than 1.0 and confirmed by scree plot. Based on 121 surveys completed by persons 60 years of age and older, the Cronbach standardized alpha was .81 for the 5-item scale. The RHCPS has potential to reveal valuable clinical and scientific data on patient-provider relationships among older adults.
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