Older adults' preferences for features of medication adherence technologies: a preference elicitation study.

Abstract

Introduction: Older adults are at risk of medication non-adherence due to complex medication regimens and medication management challenges. Medication adherence technologies can help, but previous research demonstrates variability in usability and preferences of their features among older adults. Therefore, our objective is to examine older adults' preferences for medication adherence technology features and their trade-offs to guide the development of these technologies. This will facilitate serving older adults better by addressing their needs and preference.

Methods: Guided by the Patient-Centered Benefit-Risk Framework, we conducted a questionnaire based preference elicitation study where older adults ranked 10 medication adherence technology features identified through qualitative interviews, then identified acceptable trade-offs. Recruitment of our sample was based on convenience sampling, and the inclusion criteria was older adults above 60 years and older and able to speak and read English. The ranking was evaluated by calculating the relative importance using relative importance index (RII) and the trade-offs were assessed using win rate analysis. Statistical significance was assessed using Kruskal Wallis analysis.

Results: Thirty older adults were recruited, of which twenty-three (mean age 73 years, 47.8% males) participated. The 10 reported features were button size, screen size, device size, compartment division, setting time and alarm, alarm sound, user-friendly leaflet, battery operated, locking features, and number of steps to set up the device. Screen size was ranked highest with relative importance index (RII) of 0.75. Win-rate analysis of trade-offs revealed that a user-friendly leaflet was the most frequently selected feature with p value < 0.001 (Kruskal Wallis test).

Conclusion: This study highlights the importance of understanding the preferences of older adults to guide selecting the medication adherence technology that better meet their needs, as well as developing tools supporting medication management and adherence.

Clinical trial number: Not applicable.

Supplementary information: The online version contains supplementary material available at 10.1186/s44247-025-00222-z.