Initial evaluation of a computer-based medication management tool in a geriatric clinic

Thomas R. Hornick, Patricia A. Higgins, Charles Stollings, Lawrence Wetzel, Kathryn Barzilai, Daniel Wolpaw

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Optimal management of medication regimens remains a challenge for elderly patients and their providers. Tools that aid communication and adherence can be valuable but often do not meet expectations. Objective: The purpose of this article was to describe the development and preliminary evaluation of a computer-based medication management tool, the Visual Medication Profile (VMP), and to report initial feedback from geriatric patient and provider focus groups. Methods: For VMP development, an interdisciplinary team (ie, physicians, nurses, pharmacists, computer analysts, and programmers) designed the fully automated, Web-based intervention that integrates the Veterans Affairs Medical Center (VAMC) computer pharmacy system with the computerized patient record system. In addition to development of the required technology, a mixed methods design and a convenience sample were used to collect pilot data related to patient-provider issues about medication management, and the acceptance, feasibility, and usefulness of the VMP. This involved the use of focus groups and a pilot study group. Results: First, the interdisciplinary team developed the VMP by integrating data from the pharmacy database, the patient's database, and a pill photograph database. Second, patients and providers in the focus groups discussed medication management issues and evaluated a sample VMP. Patients (n = 8; mean age, 76 years; 5 black, 3 white) noted the following medication management problems: (1) not understanding the information provided by the physician; (2) multiple providers; and (3) unpronounceable names of medications. Providers (n = 8 [4 physicians, 4 nurse practitioners]) noted that patients and providers use different language to discuss medications; that there is a lack of congruence between patients' self-report of current medications and their medical record; and that there are severe time constraints for clinic appointments and concern regarding introducing a new clinical tool. Both groups favored a VMP-like tool to improve communication. In the VMP prototype pilot study, a patient-specific VMP was developed for each of 6 subjects (mean age, 79.7 years; 3 black, 3 white) from the outpatient geriatric clinic. Congruence rates ranged from 51% to 100%. Five of the 6 subjects participated in follow-up. The nurse's telephone log from the pilot study revealed that although 4 out of the 5 subjects and/or caregivers reported that they favored the VMP as a medical management tool, the use of the VMP at home varied considerably. Conclusions: The VMP is a promising tool for use by both patients and providers to improve medication management. Although it was developed in the VAMC system, its Web-based platform has the potential for export to other systems.

Original languageEnglish (US)
Pages (from-to)62-69
Number of pages8
JournalAmerican Journal Geriatric Pharmacotherapy
Volume4
Issue number1
DOIs
StatePublished - Mar 1 2006

Fingerprint

Geriatrics
Focus Groups
Veterans
Databases
Physicians
Nurses
Communication
Nurse Practitioners
Computer Systems
Ambulatory Care Facilities
Pharmacists
Telephone
Self Report
Caregivers
Names
Medical Records
Appointments and Schedules
Language
Technology

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Pharmacology (medical)

Cite this

Hornick, Thomas R. ; Higgins, Patricia A. ; Stollings, Charles ; Wetzel, Lawrence ; Barzilai, Kathryn ; Wolpaw, Daniel. / Initial evaluation of a computer-based medication management tool in a geriatric clinic. In: American Journal Geriatric Pharmacotherapy. 2006 ; Vol. 4, No. 1. pp. 62-69.
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Initial evaluation of a computer-based medication management tool in a geriatric clinic. / Hornick, Thomas R.; Higgins, Patricia A.; Stollings, Charles; Wetzel, Lawrence; Barzilai, Kathryn; Wolpaw, Daniel.

In: American Journal Geriatric Pharmacotherapy, Vol. 4, No. 1, 01.03.2006, p. 62-69.

Research output: Contribution to journalArticle

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