Federico Botella

A Spanish Pillbox App for Elderly Patients Taking Multiple Medications: Randomized Controlled Trial

Background Nonadherence and medication errors are common among patients with complex drug regimens. Apps for smartphones and tablets are effective for improving adherence, but they have not been tested in elderly patients with complex chronic conditions and who typically have less experience with this type of technology. Objective The objective of this study was to design, implement, and evaluate a medication self-management app (called ALICE) for elderly patients taking multiple medications with the intention of improving adherence and safe medication use. Methods A single-blind randomized controlled trial was conducted with a control and an experimental group (N=99) in Spain in 2013. The characteristics of ALICE were specified based on the suggestions of 3 nominal groups with a total of 23 patients and a focus group with 7 professionals. ALICE was designed for Android and iOS to allow for the personalization of prescriptions and medical advice, showing images of each of the medications (the packaging and the medication itself) together with alerts and multiple reminders for each alert. The randomly assigned patients in the control group received oral and written information on the safe use of their medications and the patients in the experimental group used ALICE for 3 months. Pre and post measures included rate of missed doses and medication errors reported by patients, scores from the 4-item Morisky Medication Adherence Scale (MMAS-4), level of independence, self-perceived health status, and biochemical test results. In the experimental group, data were collected on their previous experience with information and communication technologies, their rating of ALICE, and their perception of the level of independence they had achieved. The intergroup intervention effects were calculated by univariate linear models and ANOVA, with the pre to post intervention differences as the dependent variables. Results Data were obtained from 99 patients (48 and 51 in the control and experimental groups, respectively). Patients in the experimental group obtained better MMAS-4 scores (P<.001) and reported fewer missed doses of medication (P=.02). ALICE only helped to significantly reduce medication errors in patients with an initially higher rate of errors (P<.001). Patients with no experience with information and communication technologies reported better adherence (P<.001), fewer missed doses (P<.001), and fewer medication errors (P=.02). The mean satisfaction score for ALICE was 8.5 out of 10. In all, 45 of 51 patients (88%) felt that ALICE improved their independence in managing their medications. Conclusions The ALICE app improves adherence, helps reduce rates of forgetting and of medication errors, and increases perceived independence in managing medication. Elderly patients with no previous experience with information and communication technologies are capable of effectively using an app designed to help them take their medicine more safely. Trial Registration Clinicaltrials.gov NCT02071498; http://clinicaltrials.gov/ct2/show/NCT02071498 (Archived by WebCite at http://www.webcitation.org/6OJjdHVhD).

Distributed user interfaces

This document exposes the most relevant issues regarding the development of Distributed User Interfaces (DUIs) to present the specific features that are not covered by traditional development processes. A transversal approach to tackle these new aspects is also proposed. Therefore, the goal of this workshop is to promote the discussion about the emerging topic of distributed user interfaces, answering a set of key questions: what, when, how, why distribute a user interface among different devices.

A new proposal for improving heuristic evaluation reports performed by novice evaluators

In this paper, we propose a new approach to improve the results of the heuristics evaluation performed by novice evaluators combining the classical usability reports with the interaction pattern design in concrete types of usability problems. Normally, usability reports generated by experts or by any automatic tool are limited to a list of problems detected with qualitative and quantitative data plus graphics or simple suggestions for solving detected problems. Sometimes these suggestions are not sufficient to fix the detected problem, as the designer is not able to capture or reproduce the problem. Our proposal will provide support to designers, trying to unify the recommendations offered by evaluators introducing the concept of design patterns in the report. In this manner, the final report could be enriched with one design pattern for some of the detected usability problems, thus enabling a better understanding of the detected issue by designers.

Distributed User Interfaces: Specification of Essential Properties

In the last few years, the traditional concept of user interface has been changing significantly. The development of new surprising devices supporting new amazing interaction mechanisms have changed the way in which people interact with computers. In this environment of strong technological growth, the increasing use of different displays managed by several users has improved user interaction. Combining fixed displays with wearable devices allows interaction and collaboration between users when they work together in a common task. Traditional user interfaces are evolving towards “distributed” user interfaces according to the new technological advances, allowing one or more interaction elements distributed among many different platforms in order to support interaction with one or more users. This paper offers a formal view of distributed user interfaces (DUI) as a mean to understand better their essentials properties and to establish the bases for formally proving properties as correctness and coherency. The proposal has been applied to a case study.

Safer virtual pillbox: assuring medication adherence to elderly patients

In this paper, we describe a new mobile application for assisting to elderly patients and their caregivers (familiars, physicians, pharmacist) in the medication management at their homes. This mobile application will help patients to maintain medication adherence in a reliable and correctly intake of their drugs. The main target users of this application are polymedicated, polypathology and over 65 years old patients. The application was designed using User Centered Design (UCD) methods, taking always into account the characteristics of these target users, so usability and accessibility principles were applied in the design of interfaces. The design has been tested with a pre-test group of selected patients and we have confirmed that patients using this mobile application have increased their medication adherence and have reduced the frequency of adverse drug events.

A Proposal to Validate the User's Goal in Distributed User Interfaces

Traditional user interfaces are evolving toward “distributed” user interfaces according to the new technological advances, allowing one or more interaction elements distributed among many different platforms in order to support interaction with one or more users. In this new scenario, the Abstract User Interface (AUI) model has been reviewed and modified to include specific characteristics from the Distributed User Interface (DUI) point of view. This article proposes a new AUI that takes into account the possibility of distribution. Before presenting this new AUI model, the article introduces the definition of the DUI concept and its foundations using a formal notation. Together with the new AUI model, a double hierarchy of user interfaces and targets has been defined, so the type of distribution can be verified using the concept of finality introduced as an algorithm in this article. With this new algorithm it is possible to test whether a given DUI (multiple devices, multiple user interfaces) supports the users goal in the system.

How efficient can be a user with a tablet versus a smartphone

We can see at these days a large number of users utilizing a smartphone or a tablet as their daily working tool. Many professionals are changing the use of their desktop computers by using their mobile devices due to trends in their business. Thus, we can find more enterprise mobile apps that allow users to manage their companies using a mobile device in a more efficient and effective way and everywhere. This growing demand for mobile applications has become a challenge for current developers. We can find more and more enterprise applications delivered in three versions: desktop, tablet and smartphone. However, it is difficult to determine how productive a user can be in each version. In this paper we present a comparative usability study of one management mobile application designed for smartphone and tablet platforms for measuring the efficiency of the tablet version versus the smartphone version. We conducted a study with 8 participants to measure the efficiency of one mobile app and also measured the perceived usability using SUS questionnaire. This way, we obtained a ratio of the efficiency of using a tablet compared to a smartphone that could be significant for the development of future apps in small screens.

How to classify to experts in usability evaluation

Usability inspections are a set of methods for evaluating one interactive system by experts. They try to find possible usability problems and determining the level of usability of the system without involving real users. One of these methods is heuristic evaluation, where several experts inspect one system or its interface for searching usability issues. Some authors maintain that evaluation by experts in usability discovers more usability issues than evaluation conducted by non-experts. But the question is how to determine the degree of expertise of an evaluator. In this paper we will propose a classification of evaluators based on the university degree obtained or the number of hours of practice gathered in this field. One user could be classified as expert depending on his/her professional career and not only by university degrees. This is why it is important to collect other attributes of each user like domains, skills or projects to determine their expertise. We finally present how to validate these attributes by other users of the proposed repository.

Using Interaction Patterns in Heuristic Evaluation

Heuristics give some general principles or reflections that should be taken into account when an interface is being developed. Heuristic evaluation should end with a set of recommendations or advices directed to the responsible of the application or web site. Interaction patterns have reached a certain level of maturity. Designers and developers are offered different pattern catalogues that help them to design usable interfaces and better interactions. In this paper, a method to use interaction patterns in heuristic evaluation is proposed. The idea is to establish a correspondence between each heuristic and one or more interaction patterns. After presenting this correspondence, the paper illustrates the concepts by showing a real case.

An Online Travel Agency Comparative Study: Heuristic Evaluators Perception

Forming usability professionals, particularly heuristic evaluators, is a challenging task. Heuristic evaluation is a well-known and widely employed usability evaluation method. A heuristic evaluation may be performed based on generic or specific heuristics. A key issue is how new heuristics are validated and/or evaluated; heuristic quality scales were proposed. The paper presents some recurrent problems when teaching the heuristic evaluation method. It also discusses novice evaluators’ perception over Nielsen’s usability heuristics, based on empirical data. The experiment that we made involved Computer Science graduate and undergraduate students, enrolled in a Human-Computer Interaction introductory course. 50 Chilean students and 18 Spanish students participated. The online travel agency Atrapalo.com was used as case study. We used a questionnaire that assesses evaluators’ perception over a set of usability heuristics. It rates each heuristic individually (Utility, Clarity, Ease of use, Necessity of additional checklist), but also the set of heuristics as a whole (Easiness, Intention, Completeness).