Educating older adults to avoid harmful self-medication

M'Lan

et al. 2010

Ageing Int

A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N=160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p=.001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p=0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.

Section: Methodsmentioning

confidence: 99%

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial

M'Lan

et al. 2010

Ageing Int

“…17 Educational interventions aimed at increasing older (aged 60 and over) patients’ knowledge and self-efficacy for avoiding adverse self-medication behaviors demonstrated positive clinical outcomes. 18,19 …”

Section: Introductionmentioning

confidence: 99%

A qualitative study of older adults and computer use for health education: ‘It opens people's eyes’

Alicea-Planas

Journal of Communication in Healthcare

Anderson

2011

Adults over the age of 60 struggle with achieving target blood pressure readings due to difficulties seeing, hearing and understanding medical information which can result in poor adherence and drug interactions that can be fatal. According to the Institute of Medicine (2000) approximately 10% of adverse drug events may be attributed to communication failure between the provider and patient. Informing patients of potential drug interactions with over-the-counter (OTC) medications, supplements and alcohol use can contribute to better blood pressure control. The Next Generation Personal Education Program (PEP-NG) was designed to improve patient care by educating both older adults and their providers about the dangers of adverse drug interactions arising from self-medication. This web based program analyzes information entered by the patient user (with a stylus on a tablet computer) and delivers tailored interactive educational content applicable to the user’s reported medication behaviors. This qualitative study demonstrated that even amongst participants that may not feel computer literate (older-age generation) it can be a useful tool for information dissemination and also a successful way to improve communication between provider and patient.

“…Formative research conducted with two focus groups of older adults (aged 64–92) tested two different scale formats for a separate self-efficacy measure (Strickler, Lin, Rauh & Neafsey, 2008). The first format used a numeric scale from 0–10 with 0 labeled “not at all sure” and 10 labeled “totally sure” as suggested in a guide to self-efficacy scale development for low-literacy populations (Bandura, 2006).…”

Section: Procedures For Instrument Developmentmentioning

confidence: 99%

“…The first format used a numeric scale from 0–10 with 0 labeled “not at all sure” and 10 labeled “totally sure” as suggested in a guide to self-efficacy scale development for low-literacy populations (Bandura, 2006). The second format used a five-point scale with five boxes labeled with verbal descriptors “not sure,” “a little sure,” “more or less sure,” “very sure,” and “totally sure.” The older adult focus group participants unanimously preferred the five-point scale with word anchors over the numeric scale (Strickler, Lin, Rauh & Neafsey, 2008). An example of a typical comment by older participants was that they could not determine “what a score of 7 would mean” on the numeric 0–10 scale.…”

Section: Procedures For Instrument Developmentmentioning

confidence: 99%

Psychometrics of the Computer-Based Relationships With Health Care Provider Scale in Older Adults

Anderson¹,

Peabody³

2011

J Nurs Meas

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.