Tech for Better Care: Personalised community medication support and management project

Funding

This project is funded by the Health Foundation, Tech for Better Care funding stream (FR-0004830).

What is the research question?

This is phase one of a Health Foundation funded project, focusing on discovery work, to understand the challenges people face in managing their medications and review the provision of medication aids by local health and care providers.

What is the problem?

Increased life expectancy means that many older adults will develop long term conditions, such as hypertension, diabetes, arthritis, dementia or cardiovascular disease. As a result, older adults are often prescribed 6 or more medications.  Adherence – the extent to which a patient acts in concordance with the dose and dosing interval of the prescribed medication – then becomes a major challenge. Studies have found that 24% of older adults aged over 79 may not understand their dosing regimen. Non-adherence is associated with poor memorisation and increased number of medicines and age-related sensory changes; other predictive factors include the cognitive ability and level of education. Estimates of the incidence of non-adherence in older adults can be as high as 30%, in spite of the introduction of medication aids. The hidden economic costs of non-adherence are huge, this is not only in terms of wasted prescription, but more significantly in the increased burden of disease.

In Bristol, patients are having difficulty with medication, are assessed by their local pharmacist and may be referred to a local authority technology enhanced care team, who can provide one of a number of medication aids. Any support is means tested and there are a limited range of devices available with limited follow up, or opportunity to provide a personalised solution.

What is the aim of the research?

There project will explore whether there is an opportunity to use technology to better support individuals with their medication beyond the current provision and to provide more personalised support.

1. Can we proactively and effectively identify people who need assistance in taking their medications?
2. Is the current provision of medication aids by pharmacies, health or social services, equitable and effective?
3. Is there potential for hospital link workers, or other care providers, to use digital technologies to provide personalised support for patients and carers who need help taking their medications.

The outputs of this research will then be used to apply for phase two funding to explore the practicalities of delivering a Personalised Medication Support Service.

How will this be achieved?

There are smart or intelligent assistive technologies, that have the potential to provide individualised support for people with sensory or cognitive impairments to take their medications. The initial focus of this project is to explore whether there might be potential for home from hospital Link Workers to use these new digital technologies to provide personalised relational support for people who have taking multiple medications.

There are three work packages to enable us to understand the current situation:

Work Package 1: Home visits to service users who are discharged from hospital, to explore their needs. Use of online and postal surveys to reach a wider sample.

Work Package 2: Review of the provision on medication aids provided by local authority TEC teams. Interviews of stakeholders to understand their perspective.

Work Package 3: Focus groups with service users, and health and care professionals.

Who is leading the research?

The research is led by Debbie Campbell, Chief Pharmacist at the Bristol, North Somerset and South Gloucestershire Integrated Care Board and Prof. Nigel Harris, previously Director of Innovation and Growth, West of England Health Innovation Network and visiting Professor at the University of the West of England.

The study is a collaboration with Sirona Care and Health, Bristol, North Somerset and South Gloucestershire Local Authorities, Age UK Bristol and Age UK BANES, together with a number of community organisations.

Further information:

For more information or to get involved in this project, please email bnssg.research@nhs.net