Screening for Medication IQ and Managing Medication

描述（由申请人提供）：研究表明，平均而言，50%的老年人难以按照处方服药，并且对药物治疗的依从性差是美国1000亿美元的医疗保健问题。当涉及到药物依从性时，老年人是一个重要的用户群体，至少有四个原因：1)他们比年轻人服用更多的药物，并且明显有更多的依从性问题，2)这个国家的老年人数量正在迅速增加，使他们成为最大的使用者群体之一，3)药物依从性是日常生活活动的关键活动，4)老年人有独特的需求，因为与年龄相关的感觉-知觉，运动控制和认知能力下降。最近一项对药物依从性的综合评估指出，认知障碍是导致依从性差的主要因素，其次是药物治疗方案的复杂性。目前还没有药物治疗方案复杂性的量表或药物服用能力的评估。这种信息的缺乏导致决策不足，并导致医疗保健状况不佳。第一阶段SBIR提案有三个主要目标。首先，开发一种计算机化的测试——药物智商测试——它将可靠地确定老年人是否可能经历认知困难，从而使他们面临服药的风险。其次，开发一个药物复杂性度量来预测用药方案复杂性、心理能力和药物管理支持性质之间的相互作用。第三，开发药物依从性优化算法，以最大限度地减少药物治疗方案的认知需求，并最大限度地提高依从性。我们将开发一种药物依从性筛查技术，因此在未来，随着患者用药方案复杂性的增加和/或认知功能的下降，MedicationlQ测试将成为辅助医疗保健管理的常规测试。这种筛查标准在PCP实践中很常见（例如，根据年龄和病史筛查乳腺癌或前列腺癌）。MedicationComplexityMetric将为医疗保健专业人员提供与药物治疗方案复杂性相关的预测规范，而药物依从性优化算法将确定如何修改药物治疗方案以提高药物依从性。

DESCRIPTION (provided by applicant): Research suggests that, on average, 50% of older adults have difficulty taking medications as prescribed and poor adherence to pharmacological therapies is a $100 billion healthcare problem in the United States. Older adults are an important user group to study when it comes to medication adherence for at least 4 reasons: 1) they take more medications than their younger counterparts and have significantly more adherence problems, 2) the number of older adults in this country is rapidly increasing making them 1 of the largest user population, 3) medication adherence is a critical activity of daily living activities, 4) older adults have unique needs due to age-related declines in sensory-perceptual, movement control, and cognitive abilities. A recent comprehensive review of medication adherence noted that a primary factor identified with poor adherence was cognitive impairment, with complexity of the medication regimen a second factor. There is at present no scale of medication regime complexity or assessment of medication taking competence. This lack of information results in deficient decision making and contributes to poor healthcare. This Phase I SBIR proposal has 3 primary goals. First, to develop a computerized test-MedicationIQ test-that will reliably identify whether older individuals may be experiencing cognitive difficulties that place them at risk for medication adherence. Second, to develop a MedicationComplexityMetric to predict the interaction of medication regime complexity, mental competence and nature of medication administration support. Third, to develop Medication Compliance Optimization algorithms to minimize the cognitive demands of a medication regime and maximize adherence. We will develop a technology for medication compliance screening so in the future, as patients medication regime complexity increases and/or cognitive function declines, the MedicationlQ test will become routine to aid health care management. Such screening criteria are common in PCP practices (e.g., screens for breast or prostate cancer based on age and medical history). The MedicationComplexityMetric will provide the health care professional with predictive norms relating to the complexity of the medication regime and the Medication Compliance Optimization algorithms will identify how modifications in the medication regime might improve medication adherence.