RESNA 26th International Annual Confence
The Med-Manager is a technology interface which serves to remind users to take their medication. It is designed for individuals taking multiple medications who may experience difficulty remembering which medication to take, the time of day it needs to be taken at and the quantity to be taken. There are a variety of functional issues that the Med-Manager attempts to address. First of all, for those taking special drugs, the need to take them can be crucial for their ability to function- not taking the medication will reduce functional performance in the area that the medication is intended to address. If the individuals are able to take the suitable amount of medication at the appropriate time, it would help to optimize their functional performance. Many individuals have trouble remembering to take their correct dosage at a constant frequency on a schedule (Trotter, 2001). Additionally, due to the fact that individuals who take a variety of medications are required to spend time taking them, either by being at home during the specific times or constantly being aware of the need to take them, the individual may have less freedom to engage in other activities (i.e. leisure, productivity). Trotter, in his paper on geriatric medication use, made the point that complex medication regimes involving many drugs and varying dosing schedules compromise patient adherence (2001). The Med-Manager could help this adherence problem. Finally, or those people that may have cognitive or emotional difficulties (i.e. memory or stress) the Med-Manager will help to alleviate the impact that these difficulties have on an individual's everyday functioning.
The Med-Manager is similar in shape and size to a PDA (personal digital assistant) and is a device that will not draw to much attention to it as being out of the ordinary. The screen of the Med-Manager dominates the front of the unit and is 3.5 inches, by 3 inches in size and displays dark text on a light background, a visual scheme which has be found to be most optimal for the general population (Emlet et al., 1996). In clock mode, the date and time are displayed. This acts as the standby screen. The Med-Manager alerts the patient when it is time to take their medication. This alert can be in the form of a sound, vibration, or flashing light, chosen by the user by the 3 large buttons on top. This allows for individual alert preference and can accommodate people with various sensory deficits. When the Med-Manager is alerting the person, the screen will display which medications, and how many, the individual needs to take. This is done this by showing the number to take, as well as colored geometric shapes that correspond to the pill container. The shapes will be color coded to the same shape and color as the sticker on the pill containers. The colors used will be those that are most easily seen by individuals across the life span. For example, bright colors such as red, orange, yellow and brown are easily distinguished on various backgrounds (Emlet et al, 1999). Blues, greens and like colors are more difficult to view as you age ("Aging Eye", 2002). However, if the color can't be recognized, then the shape is still easily recognizable. Care would also be taken to ensure that colors such as red and orange would not be placed near each other to allow for greater differentiation. As a safeguard the name of the medication will also appear on the screen in case there is confusion to which color is being shown. The screen is covered with an anti-glare coating to allow greater visual acuity- especially for older adults who may have particular difficulty with glare ("Web Accessibility Initiative", 2002). The font used on the screen is a sans-serif 16 point font. Although serif fonts are easier to read in paragraph form, sans-serif fonts keep the display clean and simple. Larger size fonts, such as 14 point and up, have been found to be the easiest to read for the older adult ("Web Accessibility Initiative", 2002). Once the alert has sounded it can be turned off by pressing the large red button on the front of the device, which will again go off in 15-second intervals to ensure that the medication has been taken. The clock mode will return to viewing after 5 minutes. If the screen is cleared before checking the medication, it can still be viewed by pressing the red button until the next time that medication is taken.
All information in the Med-Manager is stored on a smart media card. In the Med-Manager system, the pharmacist would be responsible for programming everything into the card. The memory card can be updated as prescriptions are changed, renewed or finished. It is also the pharmacist's responsibility to place the corresponding colored shapes that will be seen on the display, on the pill containers. The device will also alert the individual when the prescription is to be renewed. Reprogramming by the pharmacist is the only way for any information to be changed.. Patient medical history will be also be stored in the memory card in order to allow other healthcare professionals, such as paramedics, the capability to access essential patient information. For example a paramedic may come across an unconscious individual who owns this device and will be able to look up the medication history to receive more information and help provide the best and fastest care possible.
The Med-Manager's size to allows for easy portability. At five inches in length, and three-quarter inches thick, it fits easily into most pockets. Often individuals can be deterred from using technological devices, especially ones with many buttons, however, this particular device has been simplified to contain as few buttons possible to make it easy to use by everyone.
The Med-Manager provides the opportunity for individuals to maintain independence in medication management. "The prevalence of polypharmacy and complex medication regimes coupled with age-related changes make the older adult prone to experience adverse drug reactions and interactions" (Trotter, 2001). This type of product allows for individuals to gain control of their medication management and decrease the likelihood of drug related problems and adverse side effects. The average community based older adult fills eleven prescriptions per year (Emlet et al., 1996). It is likely that confusion, misunderstandings, or slight memory difficulties could result in medication mismanagement. Gaining the control of this will help to maintain a person's independence and allow them to have a greater chance of remaining in their home because they can demonstrate ability to take care of themselves. It will also decrease feelings of dependence on family or other health care professionals who may have remind them consistently about their medications.
This device is not restricted to use by older adults. Individuals of all ages may need to take numerous medications during various times in their life. For example, children who need to take medications while at school can use the Med-Manager to alert their teacher that they require their medications; therefore decreasing the responsibility of a school nurse or teacher for this added job.
Above all, the Med-Manager will allow individuals to go through their day without having to worry about missing the time to take the medication and can allow for the individuals to experience more in their life.