Technical Factors Associated with Polypharmacy Management Through Leavitt’s Sociotechnical Model

Abstract

Background: Global advancement toward aging highlights inappropriate polypharmacy in the elderly as an increasingly critical health issue. Addressing this challenge can reduce adverse drug reactions and physical and cognitive impairments and improve older adults’ quality of life. Objectives: This study aimed to analyze the technical aspect of polypharmacy management in the elderly with comorbidities through the socio-technical model for change management to help develop future roadmaps of current affairs. Methods: The present qualitative study was performed by conducting 35 semi-structured interviews with key informants selected by maximum variation purposive sampling in 2022. The interviews continued until theoretical saturation. To extract all factors in all domains of the health complex system, the WHO Health System Six Building Blocks factors were investigated through Leavitt’s socio-technical model for change management. Data were analyzed using thematic content analysis with MAXQDA10 software. Results: The “Structure” and “Technology” dimensions of Leavitt’s model each consisted of two blocks of the WHO Framework. Regarding “Leadership & Governance” and “Financing” (structure), the following themes were identified: developing databases, optimizing homecare, and pharmaceutical cost management. In the blocks of “Medicine &Technology” and “information,” three other themes emerged: developing medicine formulations, innovative technologies, and technology-based self-care. The interviewees considered the “Structure” the most critical transitional factor in polypharmacy management. Conclusions: Stimulating, designing, and implementing strategies for polypharmacy change management requires identifying transitional factors by holistic approaches. Furthermore, shifting toward sustainable changes is possible based on well-developed infrastructures and adopting innovative, user-friendly technologies.