Systems-Based Patient Work Analyses of Older Adults with Heart Failur

This doctoral research explores the medication management work of older heart failure patients, with a focus on cognitive work amenable to tool and technology interventions. The goal was to gather the knowledge to guide the design of effective tools and technologies to improve medication management performance, medication adherence, and health outcomes. Medication mismanagement, adverse drug events, and medication non-adherence in heart failure patients are common, with devastating consequences for society, the healthcare system, patients, and their families. Technology and tools have the potential to improve medication management by patients, but only based on an explicit understanding of users, their tasks and their environments [1]. Insight into the work a tool is intended to support is the starting point for the design of effective tools [2]. Therefore, the design of tools and technologies to improve patient performance requires a deep understanding of their medication-related work activities and context. A literature review, however, yielded few studies addressing medication management as a goal-oriented process rather than an adherent/non-adherent behavior. Also, few tested methods to acquire this knowledge and few studies directed at the design of tools exist.