Taking one’s medications as they were prescribed is essential to managing disease but sometimes a challenge in adults undergoing age-related or other kinds of memory changes. Using theory and evidence specifically about prospective memory (remembering to do something you intend to do), University of Arizona College of Nursing Professor, Dr. Kathie Insel, is striving to assure that older adults are helped to take their medications as prescribed. Having learned that cognitive functions called executive function and working memory (associated with successful prospective memory) also affect remembering to take medications, in prior work, Dr. Insel tested the behavioral intervention designed to support prospective memory and improve remembering to take medications. Applying the results of her prior research, which has been years in development, she and her team are now debuting a mobile app that could have wide-reaching implications for helping older adults in general and others who experience certain brain changes as a consequence of illness and/or treatment, e.g., treatment with chemotherapy sometimes referred to as “chemo brain”.
Dr. Insel and her colleagues, Dr. Jeannie Lee from the UA College of Pharmacy, Drs. Wendy Rogers and Dan Morrow from the University of Illinois, Dr. Gil Einstein of Furman University and Dr. Tracy Mitzner of Georgia Institute of Technology, are working with local Tucson company Ephibian to design and execute an app for smartphones that translates the essence of Dr. Insel’s behavioral intervention into consistent daily reminder support and more. The overall intent is to make self-management of chronic conditions easier and more successful, thus promoting continued independent living for as long as possible among older adults.
“In the world of cognitive psychology, study after study has demonstrated differences between younger and older people and the way they process information and remember” says Dr. Insel, pointing to the two types of memory, retrospective memory (remembering something you did) and prospective memory (remembering to do something you intend to do). “My work is addressed to new terrain. To date, little attention has been focused on translating what is known about prospective memory into specific supportive strategies that can be put in the hands of patients and therefore enhance older adults’ capacity for self-management.”
Now, thanks to a $275,000 National Institute of Health (NIH) R21 research grant, Dr. Insel and her colleagues will transform the behavioral intervention to a smartphone application (app) and test its influence on medication-taking by patients grappling with high blood pressure. “People think older adults don’t use smartphones, but there’s a generational change going on whereby older adults are more tech savvy than ever before. Furthermore, we are seeing that people are looking for apps to help with remembering to take medications. So there’s definitely a need.”
Evidence shows that as few as 50% of patients take medications as prescribed and the picture is worse when people are managing long-term illnesses such as high blood pressure as compared to short-lived illnesses such as a time-limited infection. Dr. Insel’s multi-disciplinary team has designed their MEDSReM (Medication Education, Decision Support, Reminding and Monitoring System) to have all the features the name implies. Dr. Jeannie Lee as pharmacist expert is instrumental in guiding the medication decision support, such as what to do if you forgot to take it when you intended to take it.
“This technology is a promotion of health as well as a treatment of illness,” says Dr. Insel. “The current effort is focused on those with hypertension. Uncontrolled high blood pressure is the primary cause of stroke and a cause of heart disease, retinal and kidney damage hence taking medication as intended is important. We can make a huge impact in helping people effortlessly manage their condition, stay healthier and live independently longer.”