Diaz-Skeete, Yohanca (2023) An exploration of the potential contribution of a medication management app in heart failure outpatients’ care: the experiences of staff and older patients. Doctoral thesis, Dundalk Institute of Technology.
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Abstract
Background: Managing the care of older adults with Heart Failure (HF) largely centres on symptom and medication management. Medication management in patients with HF is challenging due to frequent medication adjustments in response to changes in their symptomatology and polypharmacy. Some patients with HF typically take on average 10-25 tablets daily. Given the complexity of HF self-management, assisting older adults in managing their own care at home is critical to the success of HF management. Aim: To explore the role of a medication management app in supporting the care of older adults attending a HF outpatients ‘clinic and the impact of this new intervention on staff working practices. Methods: Mixed methods sequential design to test the feasibility of a medication app with HF patients. Observations of clinical practice were conducted followed by semi-structured interviews with healthcare professionals (HCPs) and patients pre- and post-intervention. Interviews were transcribed and analysed using thematic analysis, the Normalisation Process Theory (NPT) framework was used to capture challenges and facilitators to technology use in phase three. A systematic search of apps was also conducted to identify commercially available apps with a medication functionality, followed by an evaluation of apps using a validated tool. The optimal app was selected and implemented in a three-month intervention with patients attending the HF clinic. A case study strategy was used to present the experiences and opinions of HCPs and patients using the app. Findings: Patients normalised the use of the app and found it easy to use after training for medication self-management at home. HCPs found the use of the app to empower patients and to assist them in maintaining an up-to-date medication list and concluded that the use of the app was beneficial to both HCPs and patients. However, several challenges need to be overcome before implementing and scaling up this intervention. Some of the barriers to technology uptake identified in this study were: HCPs attitudes towards older people using technology, lack of managerial support and the need for training and ongoing technical support for older adults Conclusion: The use of the NPT framework captured individual and organisational barriers and facilitators to the normalisation of the use of the medication app with HF older patients. These barriers need to be overcome to enable the implementation and scaling up of this intervention. The findings of this feasibility study are encouraging and warrant further investigation to test the effectiveness of a medication app with HF older adults at a larger scale in future studies.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Subjects: | Social Sciences > Older people |
| Research Centres: | UNSPECIFIED |
| Depositing User: | Yohanca Diaz |
| Date Deposited: | 24 Oct 2023 15:06 |
| Last Modified: | 24 Oct 2023 15:06 |
| License: | Creative Commons: Attribution-Noncommercial-Share Alike 4.0 |
| URI: | https://eprints.dkit.ie/id/eprint/861 |
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