OUR WORK
OUR WORK
Medication Adherence Products and Strategies
Medication adherence technology (MATech) refers to any device, tool, or software designed to support patients in managing and taking their medications as prescribed by their healthcare provider. These technologies aim to improve medication adherence by helping patients organize their medications, providing reminders, tracking intake, and offering feedback to promote consistency and effectiveness in treatment.
Electronic medication adherence technologies (eMAPs) and smart medication adherence products (smart MAPs) are key examples of these innovations. eMAPs often include features like multiple compartments and alarms to remind patients to take their medications. In contrast, smart MAPs incorporate advanced connectivity technologies, such as Bluetooth and Wi-Fi, enabling real-time tracking, remote monitoring, and instant feedback between patients, caregivers, and healthcare providers. These technologies frequently include additional capabilities such as audio-visual reminders, adherence data logging, and report generation. Our team investigates the use and integration of these products in patients’ homes as well as community pharmacy.
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​​Ongoing Projects
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Development of a Digital Decision Aid for Medication Adherence Technologies
This study aims to develop and evaluate a digital decision aid designed to help older adults, caregivers, and healthcare providers choose the most appropriate medication adherence technology based on individual needs and abilities. Medication adherence technologies, such as pill organizers and automated dispensers, often include features that may not suit all users due to variations in cognitive, sensory, or physical abilities. This decision aid intends to match users with technologies that address their specific challenges.
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Medication Management and Vision Impairment: Challenges, Workarounds, and Technology
This project focuses on understanding the challenges faced by older adults with vision impairment (VI) in managing medications. It aims to develop a framework for designing medication adherence technologies tailored to different types and severities of VI, including visual acuity, contrast sensitivity, visual field, and stereopsis deficits.
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Compassion Fatigue, Compassion Satisfaction, and Automated Medication Dispensing Technology
This pilot mixed-methods study investigates the impact of automated medication dispensers (AMDs) on informal caregivers' experiences, specifically focusing on compassion fatigue, compassion satisfaction, and medication management hassles.
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Development of a Medication Management Toolkit for Care Partners of Older Adults
​This study aims to create a medication management toolkit to address the challenges informal caregivers face while supporting older adults.
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Completed Projects
User Experience with Medication Adherence Technology: Determining Usability by Capabilities
This project aimed to evaluate the effectiveness and usability of medication adherence technologies (MATech) for older adults facing diverse physical, cognitive, sensory, motivational, and environmental challenges. Conducted at the University of Waterloo's School of Pharmacy and various senior living settings, this study included 96 participants aged 60 and older. Through mixed-method research involving usability testing and semi-structured interviews, the study identified which features of MATech were most appropriate for older adults with different abilities.
Classification of Medication Adherence Products
We developed a classification system for the numerous technology-based products available to support patients and caregivers in managing their medication intake at home. The classification of adherence technologies is necessary for research and clinical practice as it facilitates clarity in communication, analysis, and comparison of the technologies. ​
Framework for Medication Adherence Dashboards
In this project, we interviewed older adults, care partners, and clinicians to determine the key features, utilities, and functionalities of an adherence dashboard. This project helped us develop a framework for the future development of adherence dashboards.​
Tools that Identify Barriers to Medication Taking in Older Adults
The ability of older adults to self-manage medications is influenced by a diverse variety of factors. We conducted a scoping review to identify tools that measure physical, cognitive, sensory (vision, hearing, touch), motivational, and environmental barriers to medication self-management in older adults. This review identified a number of validated tools to measure various challenges that older adults encounter with medication management.
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For more information read the following publications:
Baby B, McKinnon A, Patterson K, Patel H, Sharma R, Carter C, Griffin R, Burns C, Chang F, Guilcher SJ, Lee L, Fadaleh SA, Patel T. Tools to measure barriers to medication management capacity in older adults: a scoping review. BMC Geriatr. 2024 Mar 27;24(1):285.​
Clinician Guide
We have developed a Clinician Guide to help clinicians compare the different features of eMAPs when recommending a medication dispensing product to their patients.
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For more information read the following publications:
Patel T, Ivo J, McDougall A, Lee C, Chang F, Bauer J, Pritchard S. Development of a clinician guide for electronic medication adherence products in older adults. Can Pharm J 2022; 155: 119 – 127.
DSL - MMC (Domain Specific Limitation in Medication Management Capacity)
We created a tool known as the Domain Specific Limitation in Medication Management Capacity (DSL – MMC) Tool to provide a comprehensive tool with which to assess an older adult’s ability to manage their own medications.
For more information read the following publications:
Patel T, McDougall A, Ivo J, Carducci J, Pritchard S, Chang F, Faisal S, Lee C. Development and content validation of an instrument to measure medication self-management in older adults. Pharmacy 2021; 9: 78.
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We have curated a list of marketed SMART medication adherence products (SMAPs) along with their description and data capture methods. Please see the document on the right for the complete list of products. If you wish to see a more in-depth document (with information such as availability by region, detailed product features and more) of all prototype and marketed SMAPs please click here.
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eMAPs Product Comparison Guide
Features and Characteristics of eMAPS
Smart medication adherence products (smart MAPs) use a variety of connectivity options to record and communicate real-time medication intake, enabling remote monitoring. To address pharmaceutical nonadherence, a variety of such products with various properties are offered. For clinical decision-making, a comparison of the features of these products is required and this was conducted by our team.
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For more information read the following publications and posters:
Faisal S, Ivo J, Patel T. A review of features and characteristics of smart medication adherence products. Can Pharm J 2021; 154: 312 - 323.
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Integration of Smart Medication Adherence into Homes
Little is known about how older adults integrate smart adherence products at home. Before effectiveness can be evaluated, it is vital to look into the facilitators and barriers older people have when incorporating these products into their medicine-taking routines. Our team analyzed the integration of these products and aimed to comprehend the behaviours associated with how older adults with chronic conditions take their medications.
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For more information read the following publications:
Faisal S, Ivo J, Tennant R, Prior KA, Grindrod K, McMillan C, Patel T. Integration of a smart multidose blister package for medication intake. A mixed method ethnographic informed study of older adults with chronic disease. PLOS One 2022; 17 (1): e0262012.
Faisal S, Ivo J, McMillan C, Grindrod K, Patel T. In-home medication management by older adults: a modified ethnography study using digital photography walkabouts. Age and Ageing 2021; 1 – 11.
Faisal S, Ivo J, Tennant R, Prior KA, Grindrod K, McMillan C, Patel T. Implementation of a real-time medication intake monitoring technology intervention in community pharmacy settings: A mixed-method pilot study. Pharmacy 2021; 9: 105.
Faisal S, Ivo J, Lee C, Carter C and Patel T. The usability, acceptability, and functionality of smart oral multidose dispensing systems for medication adherence: A scoping review. J Pharm Prac 2022; 35: 455 - 468.
MAPs (Medication Adherence Products)
We examined the usability and workload of 21 different eMAPs.
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For more information read the following publications:
Faisal S, Ivo J, McDougall A, Patel T. Stakeholder Feedback of Electronic Medication Adherence Products: Qualitative Analysis. J Med Internet Res 2020; 22 (12): e18074.
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Patel T, Ivo J, Faisal S, McDougall A, Bauer J, Pritchard S, Chang F. A prospective study of usability and workload of electronic medication adherence products by older adults, caregivers and healthcare providers. J Med Internet Res 2020; 22(6): e18073.
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Medication Non-Adherence
Improving adherence to medications is an effective means in improving the health of a population, the healthcare system and limiting the costs associated with it. Our lab has researched the factors that drive medication adherence and the direct and indirect measures used to measure adherence. Ultimately developing useful strategies that healthcare providers can make use of with their patients.
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For more information read the following publications:
Patel T. Medication nonadherence: Time for a proactive approach by pharmacists. Can Pharm J 2021; 154: 292 - 296.
Stakeholder Values
One study conducted by our team looked into the value that real-time access to medication intake data and the availability of smart adherence products hold for many stakeholders, including patients, their carers, doctors, and insurers.
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For more information read the following publications:
Faisal S, Ivo J, Abu Fadaleh S, Patel T. Exploring the value of real-time medication adherence monitoring: A qualitative study. Pharmacy 2023; 11.