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PUBLISHED ; Barcelona, Spain ; Multimorbidity, the presence of two or more chronic conditions, places a significant burden on health systems globally. People managing multiple chronic conditions face burdensome and complex treatment plans. Polypharmacy, the prescription of several drugs, is typical in this cohort, adding to the treatment burden and potentially resulting in dangerous drug interactions. The goal of our work is to design a medication management application for older people with multimorbidity, and those within their care ecosystem. In this paper we present findings from interviews and focus groups with 124 participants, including older adults, informal and formal carers, and healthcare professionals. We outline six design requirements and describe how our design process is grounded in a strong, theoretical behaviour change approach that will allow us to fully evaluate the effectiveness of our design for medication management for those with multimorbidity, supported by their care network. ; This project (ProAct) has received funding from the European Union?s Horizon 2020 research and innovation programme under grant agreement No 689996.

In the Republic of Ireland (RoI), COVID-19 public health guidelines have been most restrictive for people aged 70 and over. Such individuals are most likely to avail of befriending services offered by a network of Irish organisations. The aim of this study was to explore the impact of COVID-19 guidelines on befriending service users, and to develop recommended adaptations to befriending services compatible with such guidelines. A qualitative constructivist grounded theory approach was taken to the study design and analysis, using semi-structured interviews to collect data from 11 participants by telephone between May 2020 and January 2021. Results show a grounded theory describing how older users of a befriending service maintained their personal autonomy in the face of strict government guidelines. Participants described living life as usual, often contravening guidelines, and how they chose to adapt to the situation, yielding both positive and negative outcomes. Some potential adaptations were discussed to the befriending service (including a preserved focus on the social and emotional functions of the befriending relationship, and the accommodation of collaborative decision making about communicative alternatives), but ultimately it was made clear that participants would tailor the services to their own preferences. Results have implications for befriending service design and delivery, and for public health officials who wish to support the health of older adults during the COVID-19 pandemic.

The key challenge facing healthcare systems worldwide is their ability to provide continued, well coordinated, person centred management, care and support for the increasing number of people with multiple chronic diseases. The European Union Horizon 2020 ProACT (Integrated Technology Systems for ProACTive Patient Centred Care) project aims to address this issue by utilising existing and designing new digital technologies to improve and advance home based integrated care for individuals over the age of 65 living with multiple chronic health conditions. This report presents findings from the needs analysis and scoping phase of the project conducted between January and September 2016. The aim of this phase of the project was to investigate the challenges that different actors in the care ecosystem face and how these are currently addressed in the two main ProACT trial sites: Ireland and Belgium. The findings detailed in this report will serve as crucial building blocks for the design of the ProACT system. We also present an overview of the findings from an additional trial site in Italy as part of a ProACT system 'EU transferability study'.