Translation of a Successful Behavioral Intervention to a Digital Therapeutic Self-Management System for Older Adults

Abstract

Feature at a Glance: Nonadherence to hypertension medications is associated with negative health outcomes, which is of particular importance for older adults because of the high prevalence of hypertension in this population. To promote medication adherence among this group, we translated a behavioral intervention that improved adherence by 36% into a digital therapeutic self-management system. Design strategies included interviewing older adults, conducting usability evaluations after each iteration, and engaging a team of experts from nursing, cognitive psychology, pharmacy, human factors in aging, and software development. We outline our design process that can guide translation of other behavioral interventions into digital therapeutic platforms.

Keywords: design for older adults; design strategies; digital therapeutics; health management; hypertension; mHealth; medication adherence; self-management; test and evaluation; usability.

Figure 1

MEDSReM© wireframes Note. Examples of the wireframes that were created for MEDSReM to connect medication-taking with a routine from the participant’s daily schedule.

Figure 2

Medication adherence rates before and after the MEDSReM© Field Test Note. Each participant from the field test is represented. Adherence was measured using MEMS^® caps and was defined as the percent of doses on schedule, with both the baseline and post-intervention adherence rates displayed. Mean overall adherence increased from 72.5% (SD 14.6) to 91.0% (SD 12.6), representing a statistically significant improvement (p=0.04).