ArticleJMIR human factors2016
Medication Management: The Macrocognitive Workflow of Older Adults With Heart Failure.
Article in JMIR human factors, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Caregivers' Contributions to Heart Failure Self-care: An Updated Systematic Review.The Journal of cardiovascular nursingPooled it
- Psychometric evaluation of the MEDication Literacy Assessment in Geriatric Patients and Informal Caregivers (MED-fLAG) instrument using Rasch analyses in a sample of hospitalised older adults.International journal of nursing studies advances · 2026Article
- Facilitators and barriers to medication self-management for patients with multiple long-term conditions transitioning from hospital to home.Exploratory research in clinical and social pharmacy · 2025Article
- Connecting pathogen transmission and healthcare worker cognition: a cognitive task analysis of infection prevention and control practices during simulated patient care.BMJ quality & safety · 2024Article
- Telecaregiving for Dementia: A Mapping Review of Technological and Nontechnological Interventions.The Gerontologist · 2024Review
- Article
- Conceptualization and content validation of the MEDication literacy assessment of geriatric patients and informal caregivers (MED-fLAG).Journal of patient-reported outcomes · 2022Article
- Human factors and ergonomics methods for pharmacy research and clinical practice.Research in social & administrative pharmacy : RSAP · 2021Review
- SEIPS 101 and seven simple SEIPS tools.BMJ quality & safety · 2021Review
- Approaches for Implementing App-Based Digital Treatments for Drug Use Disorders Into Primary Care: A Qualitative, User-Centered Design Study of Patient Perspectives.Journal of medical Internet research · 2021Article
- Medication transitions: Vulnerable periods of change in need of human factors and ergonomics.Applied ergonomics · 2021Article
- Medication Management Frameworks in the Context of Self-Management: A Scoping Review.Patient preference and adherence · 2021Article
- Patient Work and Their Contexts: Scoping Review.Journal of medical Internet research · 2020Article
- Older Adult Health-Related Support Networks: Implications for the Design of Digital Communication Tools.Innovation in aging · 2020Article
- The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.Applied ergonomics · 2020Article
- Roles and Role Ambiguity in Patient- and Caregiver-Performed Outpatient Parenteral Antimicrobial Therapy.Joint Commission journal on quality and patient safety · 2019Article
- Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications.Research in social & administrative pharmacy : RSAP · 2019Article
- Patient work from a context and time use perspective: a mixed-methods study protocol.BMJ open · 2018Observational
- Monitoring for change: the role of family and friends in helping older adults manage personal health information.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.Ergonomics · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundOlder adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts.
objectiveThe objective of this research was to describe and analyze the work of medication management by older adults with heart failure, using a macrocognitive workflow framework.
methodsWe interviewed and observed 61 older patients along with 30 informal caregivers about self-care practices including medication management. Descriptive qualitative content analysis methods were used to develop categories, subcategories, and themes about macrocognitive processes used in medication management workflow.
resultsWe identified 5 high-level macrocognitive processes affecting medication management-sensemaking, planning, coordination, monitoring, and decision making-and 15 subprocesses. Data revealed workflow as occurring in a highly collaborative, fragile system of interacting people, artifacts, time, and space. Process breakdowns were common and patients had little support for macrocognitive workflow from current tools.
conclusionsMacrocognitive processes affected medication management performance. Describing and analyzing this performance produced recommendations for technology supporting collaboration and sensemaking, decision making and problem detection, and planning and implementation.
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