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

Allison P Pack1, Stacy C Bailey1, Rachel O'Conor1

  • 1Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.

JMIR Formative Research
|October 17, 2024
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Summary

Adapting a technology-based intervention for medication adherence in older adults with multiple chronic conditions is feasible. Feedback from patients and clinicians will guide the implementation of this approach in primary care settings.

Keywords:
intervention developmentmedication adherenceolder adultspolypharmacyqualitative research

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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.