Understanding routines around medicine intake with data enabled design
September 2019 - June 2020
Honors Project, Year 2
Client: MedApp
Coach: Roy van den Heuvel
Click to view the published paper
The lack of medical adherence is one of the most serious issues regarding recovery from a disease or chronic use of medication. 50% of prescription medicine is not taken as prescribed and only around 15-20% are refilled at pharmacies as dictated by the doctor (Xie et al. 2008). Moreover, the lack of medical adherence adds up to 290 Billion USD in costs for patients (Cutler et al., 2018). The study attempts to put forward a more in-depth analysis of the habits and routines involved around medication intake, while also presenting HCI researchers with a new framework for researching a sensible target group "in-the- wild". The goal of the study is to determine the main pain points users experience in their daily medication routines.
In this study we focus on a specific user group, people who use medicine regularly (at least three intake moments per day or at least three different types of medication daily), and who use a digital medication reminder, such as MedApp. For the purpose of obtaining concrete, subjective data we built the study around the data-enabled design approach (Bogers et. al, 2016), combined with focus group sessions. The participants receive a sensor-enhanced pillbox, which acts as a research artifact, collecting quantitative data about the movement of the pillbox and the medicine intake moments. This data is plotted into a data canvas which will start a conversation with the participants on why they use their pillbox in this way. This reveals data on why participants show certain behaviors or habits around their medicine intake, key information for developing products that target long term increase of medicine adherence. The preliminary results show what data this research tool can gather and tests the contribution the study approach can have to the current understanding of medical adherence.
Final prototype / A case for a pillbox filled with sensors
Data showing the opening times of the pillbox / flowing from the use of the pillbox for 5 days
Conclusion
The focus group has shown the details on the routines the participants have. What can be mostly recognized is that many of the medication is taken during the eating moments. Which shows the kitchen as a repeated location for medication intake. Next to that, is the alarm function seen as the most important. However, multiple participants indicated that they mostly use it as a backup rather than an alarm after which they directly take the medication.
The study also highlighted four main difficulties the participants face. First of all, they find it difficult to take their medicine when away from home. It changes their normal routine and they have to remember to take it with them. Secondly, medicine management is difficult for safely combining medicine and medicine that needs to be taken with a time interval. Thirdly, the notification management of MedApp is hard to control for special occasions, such as when in the car. But also, the set up of the recurrence of the alarm should be more intuitive. Lastly, the reason why the participants have to take their medication is not always clear and is seen as a burden. As can be seen in the discussed literature, this has also a big influence on the medical adherence.
The second study was set up to help solve the difficulty of part one. It is hard to solve a problem if the source of the problem is not identified. At what point does it go wrong? Therefore the daily routines had to be mapped in more detail. The data enabled design method proved to be a helpful tool. The second study showed it is possible to collect data to find patterns. The collected data did agree with the actual daily patterns and did provide more insights, even to the participant herself.