The medication mismanagement system : causes, evidence of user innovation, and a view towards a product/service solution for the elderly

Abstract

Introduction: What could be easier than taking a pill? The doctor prescribes it, the pharmacist provides it and the patient swallows it with a glass of water twice a day for a cure; a very straightforward system of cause and effect. Unfortunately, statistics show that 66% of all Americans fail to take any of their prescription medicines (American Heart Association, 2009) and as a result many of the medical innovations that have increased life expectancy by 47 years since 1900 (Wan He, 2005) remain left unclaimed. So why than do Seniors, facing the pain of arthritis or the impending certainty of death from congestive heart failure, refuse to take their pills? The first half of this thesis seeks an answer to this question while debunking the view that this is a simple problem of ignorance or laziness on the part of the patient. In place of this oversimplified view, the problem of "medication management" is defined and cast in an in-depth and nuanced way that includes issues involving the patient, their caregiver, the disease state, social circumstances and financial constraints. The second half of this thesis focuses on possible solutions. While rethinking the entire medication system can result in great gains, the innovations discussed (both lead user and off-the-shelf innovations) all work within the current medication system and are addressable by product/service designers. By adhering to these two constraints the resulting solutions remain quickly implementable, cost effective and relevant to industry. In the end we find that end users have created a series of innovations and product modifications that address the physical and cognitive barriers they face, while product manufactures are innovating products and services that address the motivational issues users face.