Phenotyping Adherence Through Technology-Enabled Reports and Navigation (the PATTERN Study): Qualitative Study for...

Area of Science:

• Gerontology
• Health Informatics
• Primary Care Medicine

Background:

• Older adults with multiple chronic conditions (MCC) and polypharmacy experience significant challenges with medication adherence.
• Nonadherence negatively impacts treatment outcomes, increases adverse drug events, and diminishes quality of life.

Purpose of the Study:

• To adapt a technology-enabled intervention for medication adherence (Phenotyping Adherence Through Technology-Enabled Reports and Navigation [PATTERN]) for older adults with MCC and polypharmacy in primary care.
• To gather multilevel feedback from patients, clinicians, and administrators to inform intervention adaptation.

Main Methods:

• A formative qualitative study was conducted using semistructured interviews.
• Participants included patients (≥65 years, MCC, polypharmacy), clinicians, and administrators from a primary care setting.
• Thematic analysis was employed, guided by the Exploration, Preparation, Implementation, and Sustainment Framework.

Main Results:

• A total of 25 interviews were conducted (13 patients, 12 clinicians/administrators).
• Participants generally found the concept of technology-based medication adherence monitoring acceptable and appropriate for the target population.
• Specific concerns were identified, necessitating intervention adaptations for primary care implementation.

Conclusions:

• The technology-enabled medication adherence intervention, adapted from specialty care, is poised for primary care implementation.
• Formative feedback has highlighted key areas for intervention adaptation.
• Findings may guide future technology-based interventions, particularly those utilizing patient portals for older adults.