Applying participatory design to a pharmacy system intervention

Reddy, Apoorva; Lester, Corey A.; Stone, Jamie A.; Holden, Richard J.; Phelan, Cynthia H.; Chui, Michelle A.

doi:10.1016/j.sapharm.2018.11.012

Cited by 43 publications

(31 citation statements)

References 24 publications

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“…The Senior Section’s OTC medication inventory consists of products that are carefully selected using the Beers Criteria [ 30 ]—an evidence-based clinical practice guideline used as a source of older-adult OTC safety information—that have lower risk profiles for the treatment of allergies, coughs/colds, sleep, or pain [ 31 ]. As a component of a multifaceted pilot project examining the implementation of the Senior Section and its effectiveness at reducing unsafe medication use, pharmacy customers participated in a scenario-based semi-structured interview regarding their planned use of OTC medications [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although this analysis is specific to patients’ medication use information, the overall study examining Senior Section implementation has so far generated multiple publications describing different aspects and effects of the intervention. These publications have covered such distinct methods or topics as the explanation of the participatory design influence [ 31 ], description of the study protocol [ 32 ], descriptive analysis of patient/pharmacist encounters defined through a study data collection form, mixed-methods analysis of patient/pharmacist encounters [ 33 ], and qualitative assessment of pharmacy staff reactions to the Senior Section [ 34 ]. In addition to these publications, manuscripts currently are being prepared to address the following topics: a methods paper describing the task simulation and situational interviewing approach used to capture participants’ decisions when selecting and using OTC medications; a methods paper describing the process of classifying types of misuse and operationalizing these misuse constructs; a quantitative analysis of the Senior Section’s effect on the occurrence of standardized medication misuse classifications [ 35 ]; a qualitative analysis classifying types of OTC selection processes for older adults, including the results from a latent semantic analysis of older adults’ interviews; an industrial engineering analytic method to conceptually diagram older adults’ cognitive decision-making process while considering and selecting an OTC medication.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

et al. 2020

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The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults’ knowledge, beliefs, and attitudes inform their decision-making regarding OTC use. Situational interviews were conducted in three community pharmacies with 87 older-adult participants to capture how they intended to use an OTC medication. The interviews were transcribed and qualitatively analyzed, generating seven key themes: (1) medication use concerns; (2) following label instructions; (3) wait time until medication effect; (4) responses to medication not working; (5) decision to stop medication; (6) sources of information; and (7) safety implications. This study shows substantial variations in older-adult OTC medication use while providing insight on factors that influence older adults’ appropriate OTC medication use and, in some cases, the potential for harmful effects.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

et al. 2020

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“…PD is generally conducted as an iterative process involving multiple sessions situated to address specific and sequential design goals. 16,41 The PD session presented in this article belongs to a more comprehensive iterative design study and thereby introduces the limitation of lacking full context from conception to validation.…”

Section: Study Limitationsmentioning

confidence: 99%

Visualization of Cardiac Implantable Electronic Device Data for Older Adults Using Participatory Design

et al. 2019

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Patients with heart failure (HF) are commonly implanted with cardiac resynchronization therapy (CRT) devices as part of their treatment. Presently, they cannot directly access the remote monitoring (RM) data generated from these devices, representing a missed opportunity for increased knowledge and engagement in care. However, electronic health data sharing can create information overload issues for both clinicians and patients, and some older patients may not be comfortable using the technology (i.e., computers and smartphones) necessary to access this data. To mitigate these problems, patients can be directly involved in the creation of data visualization tailored to their preferences and needs, allowing them to successfully interpret and act upon their health data. We held a participatory design (PD) session with seven adult patients with HF and CRT device implants, who were presently undergoing RM, along with two informal caregivers. Working in three teams, participants used drawing supplies and design cards to design a prototype for a patient-facing dashboard with which they could engage with their device data. Information that patients rated as a high priority for the “Main Dashboard” screen included average percent pacing with alerts for abnormal pacing, other device information such as battery life and recorded events, and information about who to contact with for data-related questions. Preferences for inclusion in an “Additional Information” display included a daily pacing chart, health tips, aborted shocks, a symptom list, and a journal. These results informed the creation of an actual dashboard prototype which was later evaluated by both patients and clinicians. Additionally, important insights were gleaned regarding the involvement of older patients in PD for health technology.

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“… 13 Beginning in 2016, a redesign of the physical layout of the OTC aisles (the Senior Section) was implemented in four Midwest pharmacies to facilitate effective engagement between pharmacy staff and community-dwelling older adults; a recent article describes the participatory design process leading to the Senior Section arrangement. 14 …”

Section: Introductionmentioning

confidence: 99%

Improving Patient-Pharmacist Encounters with Over-The-Counter Medications: A Mixed-Methods Pilot Study

et al. 2020

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Background and Objectives: Over-the-counter (OTC) medication use has increased safety risks for adults older than 65. Most older adults purchase OTC medications from community pharmacies, where the considerable distance or visual obstructions between the prescription area and OTC aisles undermine pharmacists’ ability to assist patients with OTC medication decisions. An innovative redesign of an abbreviated medication section specifically for older adults (called the Senior SectionTM) can facilitate pharmacy staff/patient interaction, potentially improving safe medication selection and use. This study evaluated the impact of the Senior Section on the frequency and content of OTC encounters between pharmacy staff and patients. Research Design and Methods: An intervention mixed-methods design generated data from patient OTC encounters, and interviews with two pharmacists and two technicians, throughout the study. NVivo was used to code interview transcripts, and frequencies and chi-square analyses demonstrated pre/post-intervention comparisons for the OTC encounter variables. Results: After Senior Section implementation, pharmacy staff were more likely to initiate (and be involved in) patient encounters, address more topics or problem/symptoms, provide details about OTC products, discuss appropriateness of OTC use, and discuss medication classes highlighted in the Senior Section. Pharmacy staff were less likely to need to leave the prescription department for extended periods; they also had fewer prolonged encounters or encounters about product location. Importantly, the Senior Section did not impede pharmacy workflow. Discussion and Implications: The Senior Section prompted more frequent, effective, and efficient engagements between pharmacy staff and patients, which may substantially reduce OTC-related harms among older adults. Article Type: Original Research

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Applying participatory design to a pharmacy system intervention

Cited by 43 publications

References 24 publications

Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

Understanding the Factors Influencing Older Adults’ Decision-Making about Their Use of Over-The-Counter Medications—A Scenario-Based Approach

Visualization of Cardiac Implantable Electronic Device Data for Older Adults Using Participatory Design

Improving Patient-Pharmacist Encounters with Over-The-Counter Medications: A Mixed-Methods Pilot Study

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