A Digital and Patient-Focused Approach to Safer Medication Management and Deprescribing for Older Adults Living with Frailty

Summary

Motivation:

Northern Ireland has an ageing population facing the interconnected challenges of frailty, complex medication regimens, and varying levels of health literacy.

For older people living with frailty, this combination significantly increases the risk of medication-related harm, including adverse drug events, poor adherence, and reduced quality of life.

While the need to optimise medication is clear, there is a lack of effective, patient-centred strategies that empower frail older adults to participate in decisions about their medicines.

This project addresses this critical gap by exploring how to digitally empower individuals to manage their treatments and engage in deprescribing conversations.

Underlying aim:

This project aims to investigate the relationship between health literacy, frailty status, and medication use among older people living with frailty in Northern Ireland. It focuses on identifying opportunities for deprescribing and optimising medication regimens through digitally enabled patient-centred interventions.

Specific Objectives:

1. Assess health literacy levels and frailty status among older people living with frailty in Northern Ireland using validated tools and standardised assessments.
2. Conduct a comprehensive medication review for a sample of older people living with frailty, identifying potentially inappropriate medications using validated criteria.
3. Investigate the relationships between health literacy levels, frailty status, and medication adherence.
4. Co-design, develop, and evaluate the feasibility of a patient-centred digital intervention aimed at older adults. The intervention will integrate health literacy resources, self-reported frailty measures, and a shared decision-making tool to support medication optimisation and deprescribing conversations with healthcare professionals.

Methods:

Cross-sectional survey to assess health literacy and outcome measures related to quality use of medicines.

Clinical assessments for frailty and medication review, adopting the Scottish seven steps for medicines review and the impact tool

Qualitative interviews with a subset of participants to explore their experiences and perspectives on frailty, medication use and deprescribing

A pilot/feasibility randomised controlled trial to test the acceptability and implementation of the intervention in a clinical setting, and to gather preliminary data on its effectiveness.

Impact statement:

This research has the potential to significantly improve the health and well-being of older people living with frailty in Northern Ireland by addressing the critical intersection of health literacy, frailty, and medication management.

By developing evidence-based strategies to enhance health literacy and optimise medication use in frail older adults, we can reduce the risks associated with polypharmacy, improve patient understanding and adherence to treatment plans, and potentially improve clinical outcomes.

The findings from this study will inform healthcare policy and practice, providing a foundation for more personalised and effective care for older adults.

Crucially, the development of a scalable digital intervention offers a modern, cost-effective model for supporting medication management in ageing populations, with potential for broader implementation across the healthcare system and other healthcare systems.

AccessNI clearance required

Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Sound understanding of subject area as evidenced by a comprehensive research proposal
• A comprehensive and articulate personal statement

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• First Class Honours (1st) Degree
• Completion of Masters at a level equivalent to commendation or distinction at Ulster
• Practice-based research experience and/or dissemination
• Experience using research methods or other approaches relevant to the subject domain
• Work experience relevant to the proposed project
• Publications record appropriate to career stage
• Experience of presentation of research findings

Equal Opportunities

The University is an equal opportunities employer and welcomes applicants from all sections of the community, particularly from those with disabilities.

Appointment will be made on merit.

Funding and eligibility

NOTE - This is a self funded research project and applicants will be required to provide evidence of funds to support their tuition fees and living expenses.

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.