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A mobile prototype to identify adults 55+ who have difficulty
reading or understanding prescription lab...
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ClereMed poster Can Pharm Assoc Meeting May 2014


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ClereMed poster Can Pharm Assoc Meeting May 2014

  1. 1. 21%Use a magnifier A mobile prototype to identify adults 55+ who have difficulty reading or understanding prescription labels K Grindrod, A Gates, S Leat, L Dolovich, R Slavcev, R Drimmie, B Aghaei, C Poon, S Khan Do you know if your patients can read and understand their prescription labels? • People need to be able to see, read and understand labels to safely use medications and avoid errors. • Half of labels are misunderstood.1 • Poor legibility of labels is partly to blame.2,3 • On a typical label, the store logo is the most clear and legible and has a mean font size of 13 points. • By comparison, the medication instructions and medication names have a mean font size of 9 points . • Warning labels have a mean font size of 6 points. • Low literacy, vision and cognition make it even harder.4-9 • Pharmacists can provide additional support for people who cannot read or understand labels but there is no systematic strategy in place to identify people at risk. Research question & objective Question: Can a mobile screening tool be used to identify people who cannot read or understand labels? Objective: To determine the usability and reliability of a mobile tool to identify adults 55+ who cannot read or understand labels. ClereMed is an HTML-5 prototype that simulates medication use. It is designed to be a 2min assessment of 3 things: 1. Patient’s reported ability to read or understand labels. 2. “Drag and drop” simulation where the font size increases if the patient makes an error (9, 12, 15, 18). 3. Pharmacist assessment of the patient’s risk factors for low vision. Designing ClereMed How ClereMed performed Want more information? Table. Participant characteristics (N=47) 89%Use spectacles 21%Use large print Usability. Using the validated 10-item Systems Usability Scale,10 the usability score was 76/100 meaning it had above average usability. Further, 84% of participants found ClereMed “easy to use.” Reliability. ClereMed was moderately accurate in identifying functional vision impairment but was not sensitive for mild cognitive impairment. Lessons Learned. The essential first step to designing a mobile health solution is to consult with the target audience and user experience designers. It will help define who the users are and who they are not. Apps are expensive to build so it is important to consider how the mobile tool will fit into the workflow. A good tool should improve both the quality and efficiency of care. Thank you. Our project was partly funded by an unrestricted grant from the joint University of Waterloo/Astra Zeneca adherence fund. We also give special thanks to the retirement homes in the KW area for all their help during recruitment. We do not have any conflicts of interest to declare. The problem Testing ClereMed We recruited 47 adults aged ≥55y from pharmacies, retirement homes and a low vision optometry clinic. Participants tested ClereMed on an iPad and completed a paper questionnaire on demographics, computer literacy and usability. We assessed cognition using the Montreal Cognitive Assessment (MoCA) and functional reading ability using the MNRead Acuity Chart. Participants completed a real-life simulation with different sized labels, M&M candies and a pillbox. Supporting references 1. Davis. J Gen Intern Med. 2009: 24(1):57-62. 2. Shrank. Arch Intern Med 2007;167(16):1760-65. 3. Leat. Can Pharm J 014 147: 179-187. 4. Wolf. Patient Educ Couns. 2007: 7(3):293-300. 5. Bailey. Fam Med. 2009; 41(10):715-21. 6. Latham. Ophthalmic Physiol Opt 2011;31(3):275-82. 7. Crews. Am J Public Health 2004;94(5):823-829. 8. McCann. Br J Gen Pract. 2012;62(601):e530-7. 9. Press. J Gen Intern Med 2011;26:635-42. 10.Brooke. In: Usability Evaluation in Industry. (1996). Get the code at Github Get the poster online ClereMedUniversity of Waterloo, McMaster University, Communitech