MyMediHealth - designing a next generation system for child-centered medication management.

BACKGROUND: The last mile of the medication use system requires tools to help patients comply with medication administration rules and monitor for side effects. Personal health records (PHR) and emerging user-adopted communication tools promise to change the landscape of medication management; however, no research has been done to demonstrate how these tools might be constructed to support children with special healthcare needs. The overarching goal of the MyMediHealth project was to investigate ways in which PHRs and supported applications can improve the safety and quality of medication delivery in this population. DESIGN APPROACH: This project employed user-centered design to identify requirements for a child-centered medication management system. We collected information through site visits, facilitated group discussions, and iterative design sessions with adult caregivers. Once design requirements were articulated and validated, we constructed an initial prototype medication scheduler, which was evaluated by 202 parents using scripted activities completed using an online interactive prototype. The results of this analysis informed the development of a working prototype. STATUS: We have completed a working prototype of a scheduling system, a text-message-based alert and reminder system, and a medication administration record based on web-entered patient data. IMPLICATIONS: Pilot testing of the working prototype by stakeholders yielded strong endorsement and helpful feedback for future modifications, which are now underway as a part of an expanded project to test this system in a real-world environment.

The utility of providing automated medication dose reminders to young children on chronic medication.

We investigated the effect of text message reminders about medication administration. The study concerned children with cystic fibrosis. We provided 20 children (aged 5-12 years) with pagers that they could customize. For the first two weeks, we sent friendly text messages (non-reminder content) near medication times to acquaint them with the use of the pager. For the second two weeks, we sent messages reminding children to take their medications. The parents completed a survey to assess the child's overall use of the pager and degree of participation in medication management. Sixteen out of 20 children completed the study. Of these, 14 children (88%) were able to help notify parents when medications were due. Children as young as seven years of age may be able to receive reminders about medication administration events. The pilot study demonstrated the feasibility of involving younger children in pager technology related to medication adherence.