# A qualitative study to refine and finalize the MedManageSCI prototype: A web-based toolkit to support medication self-management in adults with spinal cord injury/dysfunction

## TL;DR

Researchers refined a web-based medication management toolkit for adults with spinal cord injury/dysfunction using feedback from users to improve clarity and design.

## Contribution

The study presents a user-centered refinement process for a web-based medication self-management toolkit tailored for adults with SCI/D.

## Key findings

- Participants provided 193 specific modifications to improve the toolkit's clarity, design, and delivery.
- Participants found the web-based toolkit comprehensive and relevant for managing medications.
- Web-based delivery was perceived as more beneficial than paper-based alternatives.

## Abstract

Adults with spinal cord injury/ dysfunction (SCI/D) commonly take multiple medications for a variety of secondary conditions, and have described challenges with medication self-management. To help support medication self-management, a web-based toolkit, MedManageSCI, was co-designed by our team of researchers and adults with SCI/D, caregivers, and healthcare providers (www.medmanagesci.ca). Together, we co-developed the content areas to include in MedManageSCI, along with the design and brand considerations, to create an initial prototype of the toolkit. To finalize the prototype prior to implementation, the primary objective of this qualitative study was to further refine MedManageSCI by examining the clarity, comprehensiveness, relevance, and delivery of the toolkit modules. Cognitive interviews were conducted virtually between July 2024 and September 2024 with adults with SCI/D (N = 16). A concurrent verbal probing approach using scripted and spontaneous probes was followed. Data were coded using a pre-established coding matrix that aligned with the scripted probes. Participants provided 193 specific modifications to improve the clarity, comprehensiveness, relevance, or delivery of the MedManageSCI toolkit, which were categorized as: Comprehension, Design, and Web-based Delivery. The Comprehension category contained three subcategories: Written Refinements, Ensuring Accessibility, and Revamping Resources. The Design category contained three subcategories: Formatting Content, Streamlining Function, and Enhancing Visuals. Participants perceived the website as an ideal way to deliver the toolkit, noting several benefits of a web-based delivery in comparison to a paper-based toolkit. Overall, participants found the modules to be comprehensive and highly relevant. Further, we discuss the application of cognitive interviews for further refining the MedManageSCI prototype, recommendations to improve the comprehensibility, and the advantages of a web-based toolkit for the SCI/D population. Involving individuals with SCI/D in the development and refinement of self-management materials will help ensure that the content and resources are tailored and appropriate; thereby elevating its likelihood of uptake and dissemination during implementation.

Adults with spinal cord injury/dysfunction (SCI/D) often take a number of medications to manage secondary conditions that occur post-injury. There were few resources that comprehensively supported individuals with SCI/D in managing their medications, so our team co-designed the prototype of a web-based toolkit called MedManageSCI. Before making the toolkit publicly available online, we wanted to refine and finalize the MedManageSCI prototype. We conducted interviews with 16 adults with SCI/D from across Canada to examine the clarity, comprehensiveness, relevance, and delivery of the toolkit modules. We received feedback to improve the clarity of information and design elements. Revisions to the MedManageSCI prototype are now complete and the website is publicly available for use (www.medmanagesci.ca). Overall, participants shared both positive and constructive feedback on the web-based MedManageSCI toolkit. Our study provides insights into the benefits of including end-users in the prototype development and refinement process. Next steps of this research include examining the feasibility, acceptability, and appropriateness of MedManageSCI.