December 11, 2000

new computer program developed at UConn is helping older adults learn more about the medicines they take, putting them at less risk for harmful drug interactions.

The interactive software program, "Preventing Conflicts Between Medicines," developed by pharmacologist and associate professor of nursing Patricia Neafsey, was designed to teach aging adults about the potential interactions of prescription drugs with over-the-counter agents and alcohol.

The objectives are to help older adults learn about the hazards of self-medication, and to reduce those behaviors that would put them

at risk, says Neafsey, who is also a registered dietician.

"Older adults often take one or more prescription drugs for chronic medical problems," Neafsey explains. "They may also be taking over-the-counter medicines such as antacids and aspirin-like pain relievers that can interfere with their prescriptions. For instance, many women who take thyroid replacement hormones take calcium supplements like Tums at the same time. They don't realize that Tums reduces the absorption of the hormone," she says.

For the past year, the software has been tested in clinical trials with older adults who take prescription blood thinners and/or prescription medicine for high blood pressure and who self-medicate with pain relievers and/or antacids. Students in their senior year of nursing have been implementing the project through the New Britain Visiting Nurse Association and senior centers around the state. The older adults in the study ranged from age 60 to 92. Juliette Shellman, a doctoral student in the School of Nursing, trained and supervised the students.

Participants in the study who met age, vision, literacy, independence and medication use criteria were randomly assigned to one of three groups: A conventional group who received only a written handout of the text of the software program, a control group who received verbal information, and a group who received the new software and the written handout.

The program uses touch screen-equipped laptop computers. With a simple touch to the computer screen, users are presented with easy-to-read information and animations that illustrate and reinforce the text. Four categories are offered: blood pressure medicines, blood thinners, antacids and acid reducers, and pain relievers. Users navigate the program by pressing the "buttons" on the computer screen. A nursing student or nurse is available to explain or interpret information.

It is Neafsey's hope that the software will be used in pharmacies, senior centers and doctors' offices.

"This is the first software program created specifically for the learning styles of older adults and the first to use laptops with touch screens to educate patients. They don't have to know anything about software or computers. They just touch the screen. And they can move the laptop to avoid glare or get it into focus if they wear bifocals," she says.

"Data from the study indicate that people using the software increased their knowledge and confidence about how to avoid potential problems from self-medication. We've also been able to document a reduction in adverse self-medication behaviors in the group that used the software," says Neafsey.

Virginia Chartier, an honors nursing student in her senior year who managed the program in Mansfield, says, "We feel the laptop interactive computer program is a superior way to teach people. Traditionally, patients receive a hard copy of teaching materials and the community health nurse reviews it with them. This is a better way to teach because the animation and questions reinforce the text."

Focus groups of older adults evaluated the program during its development. "Everything was carefully evaluated - from the color and contrast, to the speed and type of animation," says Neafsey. "They didn't want high contrast colors or sound. They wanted simple language. They didn't want anything 'cutesy' - they wanted a 'humanoid' who was gender-, race-, and age-neutral. They didn't want someone who looked like an older person."

Elna Daniels, 82, who was a member of the focus groups, is a fan of the program. "It's visual, it's helpful, it's large enough so you can see the screen with or without glasses. The language is very easy to understand and it's a pleasure to look at and see the action that takes place."

Neafsey says that delivery of health information to older adults via touch screen laptops is "effective and represents a value-added component to traditional printed educational materials. It has the potential to revolutionize health care education provided by community health nurses."

Zoe Strickler, design consultant, produced the animation graphics. The program was funded by the Donaghue Medical Research Foundation.

Sherry Fisher