Project 465413

People with conditions like diabetes, kidney disease, and heart disease take medications that protect them from complications; yet, these same medications may be harmful during times of illness (such as the 'flu' or COVID-19). Guidelines recommend that healthcare providers give patients specific instruction to temporarily stop these medications during such illnesses. Unfortunately, many patients either do not receive this instruction, or do not remember it - which may lead them to need emergency department/hospital care for low blood sugar, low blood pressure, and kidney damage because the medications are not stopped. After medications are stopped, there is also a point where they should be safely restarted; when missed, this can lead to high blood pressure, high blood sugars, and fluid build-up. Throughout the COVID-19 pandemic, it has become more difficult for healthcare providers to give this counselling to patients, potentially increasing the risk of complications. Our study will provide new opportunities for patients to receive this 'sick day guidance' and to receive guidance on when to stop and restart their medications during times of illness. Our team has been working with patients and providers to understand their barriers in managing their medications while sick. We will use this feedback to work with patients, health care providers, and software developers to create a new mobile health intervention (delivered on your mobile phone, called "PAUSE") that will be designed to give patients personalized advice on how to manage their medications during times of sickness. Finally, we will have a group of patients test the intervention and use surveys and interviews to get their feedback on how well it worked for them. We have partnered with a number of decision-makers who have identified this as a priority area and who are willing to help us make this intervention widely available to patients, physicians, and pharmacists if we find it to be effective.