Methodological features of quantitative studies on medication adherence in older patients with chronic morbidity: A systematic review

Nicolò Granata, Silvia Traversoni, Przemysław Kardas, Marta Kurczewska-Michalak, Elísio Costa, Luís Midão, Anna Giardini

Research output: Contribution to journalReview articlepeer-review

Abstract

OBJECTIVES: The growing number of chronic, multimorbid older adults encourages healthcare systems to cope with polypharmacy and non-adherence. However, methodology on how to provide effective interventions to enhance medication adherence is still object of debate.

METHODS: To describe methodological features of quantitative studies concerning older adults' medication adherence, by means of a PRISMA systematic review (Scopus, PubMed, Medline). A specific focus was devoted to theoretical models and to the ABC Taxonomy model, as stated by the EMERGE guidelines.

RESULTS: 55 papers were included. Most of the studies were conducted using randomized control trials (63.6%) and focused on a single disease only (72.7%). Most of the interventions were provided by a single professional figure (70.9%). Medication adherence was mainly evaluated by means of questionnaires (61.8%) and by clinical records (30.9%). Sixteen studies considered a theoretical model in the intervention framework. The Initiation phase (ABC Taxonomy) was the most neglected.

CONCLUSIONS: Future studies upon medication adherence should account real-life challenges such as multimorbidity, polypharmacy and interdisciplinarity, analyzing adherence as a complex, holistic process.

PRACTICE IMPLICATIONS: Theoretical models may be useful to enhance the soundness of the results, to ease their comparability, to calibrate tailored strategies and to plan patient-centered interventions.

Original languageEnglish
Pages (from-to)2132-2141
Number of pages10
JournalPatient Education and Counseling
Volume103
Issue number10
DOIs
Publication statusPublished - Oct 2020

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