Medication adherence in the older adults with chronic multimorbidity: a systematic review of qualitative studies on patient's experience

• Type: Another Publication in an International Scientific Journal
• Date: 2020

Authors

Maffoni, M (Author) Other; Traversoni, S (Author) Other; Costa, E (Author) FFUP; Midao, L (Author) Other; Kardas, P (Author) Other; Kurczewska Michalak, M (Author) Other; Giardini, A (Author) Other

Journal

Title: European Geriatric Medicine

Vol. 11 No. 6

Pages: 369-381

ISSN: 1878-7649

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 36 Citations

Scopus - 42 Citations

Other information

Authenticus ID: P-00R-ZSQ

DOI: 10.1007/s41999-020-00313-2

Abstract (EN): Purpose Medication non-adherence represents a socially relevant challenge, particularly when interlinked to multiple chronic diseases and polypharmacy. Non-adherence rates affect treatment efficacy and increase health care costs. The aim of the study was to identify factors influencing medication adherence in the older adults through a systematic review of qualitative studies on patients' experience. Methods Two electronic databases were searched for qualitative studies on medication adherence in chronic diseases (hypertension, heart disease, COPD, asthma) involving people aged 65 + . The systematic review was performed according to the PRISMA statement guidelines, employing theoretical frameworks of the ABC Taxonomy of patient adherence and Three Factor model of determinants of behaviour. Results The initial database search identified 1234 records, of which 39 studies were considered eligible. Most of the studies focused on hypertension and were conducted in English-speaking countries. According to the ABC Taxonomy, Persistence and Implementation were the most often considered phases. Considering the Three Factor model, the most often reported themes were Information and Strategies upon being adherent. Stemming from the review findings and the patients' narratives, a new integrated model was proposed. It reports the patient's decisional flowchart describing barriers and facilitators (personal, social and environmental) to adherence. Conclusion Medication adherence is a complex and multifaceted process. The implementation of theoretical frameworks along with a patient-centred perspective may provide clinicians with useful suggestions for clinical practice, enhancing the patient's ability to adhere. Key summary pointsAim To investigate potential factors associated with medication adherence in the older and chronic population through a PRISMA systematic review of qualitative studies on patients' experience. Findings The main barriers and facilitators of non-adherence were found to be patients' beliefs about polypharmacy and drug prioritization, patient's experience and capabilities, prescriber-patient relationship, health literacy, treatment characteristics and complexity, family and social support. Message The present findings, derived from two well-established theoretical frameworks (ABC Taxonomy, Three Factor model) and stemming from the patient's narratives, may provide healthcare professionals with practical information to enhance medication adherence in clinical practice.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13