Reducing adverse self-medication behaviors in older adults with the Next Generation Personal Education Program (PEP-NG): Design and methodology

Abstract

A randomized controlled efficacy trial targeting older adults with hypertension is providing a tailored education intervention with a Next Generation Personal Education Program (PEP-NG) in primary care practices in New England. Ten participating advanced practice registered nurses (APRNs) completed online knowledge and self-efficacy measures pre-onsite training and twice more after completing a continuing education program. Patient participants self-refer in response to study recruitment brochures and posters. Twenty-four participants from each APRN practice (total N = 240) are randomly assigned by the PEP-NG software to either control (data collection and four routine APRN visits) or tailored intervention (PEP-NG interface and four focused APRN visits) conditions. Patients access the PEP-NG interface via wireless tablet and use a stylus to answer demographic, knowledge, and self-efficacy questions as well as prescription and over-the-counter self-medication practice questions. The PEP-NG analyzes patient-reported information and delivers tailored educational content. Patients’ outcome measures are self-reported antihypertensive medication adherence, blood pressure, knowledge and self-efficacy concerning potential adverse self-medication practices, adverse self-medication behavior “risk” score and satisfaction with the PEP-NG and APRN provider relationship. APRN outcome measures are knowledge and self-efficacy concerning adverse self-medication practices, self-efficacy for communicating with older adults and satisfaction with the PEP-NG. Time–motion and cost–benefit analyses will be conducted.

Effects of Interactive Pictorial Education on Community Dwelling Older Adult's Self Efficacy and Knowledge for Safe Medication

“…Mild to moderate improvement in self-efficacy was reported in previous studies using pictorial aids with interaction Neafsey et al, 2009). This demonstrated that the use of an educational aid, such as visual materials with active interaction, allowed older adults to use medication appropriately and increased their confidence.…”

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

“…24, 25 The trial was approved by the University Institutional Review Board (IRB) and met all HIPAA regulations prior to enrolling any provider or patient participants. The PEP-NG was tested with 160 older adults with HTN in 10 APRN primary care practices.…”

Developing and Verifying the Efficacy of “Educational Program for Promoting Appropriate Self-medication <i>via</i> Pharmacies and Pharmacists”: A Randomized Controlled Trial

“…Although education related to self-medication is provided at schools, [20][21][22][23] in reality, self-medication itself is not widely disseminated to the public, and appropriate self-medication is not being conducted. 9,[24][25][26][27] Therefore, it seems clear that continuous, effective education regarding appropriate self-medication is necessary for adults. However, although there have been reports on the efficacy of self-medication education for patients with hypertension, 28,29) few studies have examined the efficacy of selfmedication education for adults in general.…”