Diabetes is common, costly and deadly, but there is hope in the many studies showing reduced complications with control of glucose and other risk factors, but good control is not achieved for most people with diabetes. While some of the barriers lie with provider inaction, data suggest a breakdown in information flow between patient and provider. Patients supply inadequate information to the provider leading to poor management decisions. Providers supply poor instructions to leading to inappropriate patient behavior. Medication information is the most crucial: details of actual adherence and adverse events from the patient and clear instructions from providers. We will develop and test a tool to facilitate and standardize this information flow, the Computer Assisted Medication &Patient Information Interface (CAMPII) via the following specific aims.
Specific Aim 1 : The team will complete development of patient information interface which will obtain the essential information to make appropriate management decisions for - medication details, adherence, and adverse reactions including hypoglycemia. This should reduce management errors due to inadequate information and missed hypoglycemic and other adverse reactions. The interface will be web based, include voice prompts, medication pictures, and touch screen technology to mitigate health literacy barriers. The latter will emulate more familiar technologies (grocery store). Outcomes will be IBM Computer User Satisfaction Questionnaire scores and positive ratings in qualitative interviews during development.
Specific Aim 2 : Team will develop the provider medication interface to enable provider correction of incoming medication data, entry of the new drug regimen and printing of prescriptions and medication instructions, with a daily medication schedule including pill pictures, medication purpose and expected benefits and potential adverse reactions. This schedule will be useful for improving adherence and communicating to medical providers outside the diabetes clinic. The picture output will help overcome health literacy barriers;educational details may motivate better adherence. Outcomes will be IBM Computer User Satisfaction Questionnaire scores and positive ratings in qualitative interviews during development.
Specific Aim 3 : The team will assess the accuracy, acceptability, time efficiency and utility of the patient information interface for both providers and patients. Team will evaluate the completeness and accuracy of the medication information obtained by traditional and computer assisted methods against the reference standard of comprehensive multi-source interview by an experienced pharmacy expert. Patients and providers will use industry standard questionnaires and qualitative interviews to score satisfaction. Time will be assessed by program timers and direct observation. Utility will be assessed by measuring patient medication self-efficacy, adherence and medication errors in a small randomized controlled trial of CAMPII vs. controls.
Lay Abstract Patient- provider information exchange often is incomplete, inaccurate, and time consuming, increasing the chance for management errors. A Computer Assisted Medication and Patient Information Interface will be developed and tested. This will improve information flow and will be preferred by patients and providers.
