Medication adherence in older adults with chronic diseases: a scoping review of barriers, facilitators, and effective interventions.
Medication adherence in older adults with chronic diseases is a public health challenge, given the growing and irreversible aging of the population, with direct repercussions on clinical outcomes and collective wellbeing. This scope review seeks to identify the main barriers and facilitators of pharmacological adherence and effective evidence-based interventions to optimize it.
A scope review was conducted for the period 2015-2025. Forty-one observational and interventional scientific studies (clinical trials) were selected from PubMed, Scopus, Web of Science, and ScienceDirect. Initially, a search was performed in six databases covering public health, medicine, life sciences, and biomedicine (PubMed and ScienceDirect), evidence-based healthcare (Cochrane Library), social sciences, arts, and humanities (Scopus and Web of Science), and research output, with an emphasis on Latin America, Spain, and Portugal. The four databases with the largest number of publications on the older adult population were selected, including topics such as medication adherence (compliance with pharmacological treatment and prescribing recommendations), medication persistence (uninterrupted continuity in medication recovery and administration), and patient prioritization interventions using automated mechanisms. The final selection of articles was carried out by three experts, who performed a critical appraisal of the evidence. The discrepancies were resolved by two other researchers, following the identification, screening, selection and inclusion phases of the PRISMA-2020 guidelines. The analysis of the information was carried out through synthesis and narrative integration.
Individual barriers were identified, including demographic (age, sex, educational level, and income), psychological (anxiety, depression, and self-efficacy), cultural (beliefs, fatalism, and stigmas), physical and mental health status (multimorbidity and cognitive impairment), and pharmacological (number of medications and adverse effects) factors. Facilitators identified are related to the health system (continuity of care, fragmentation of care, assertive communication, access, and provision of medicines). The interventions include personalized health education.
Medication adherence in older adults should be addressed with comprehensive and sustainable interventions. These interventions combine pharmacist education, technological support, continuous monitoring, and patient participation in therapeutic decision-making. Strategies should be designed with a collaborative approach involving patients, families, and healthcare professionals, ensuring measurable clinical outcomes and improving their quality of life.
A scope review was conducted for the period 2015-2025. Forty-one observational and interventional scientific studies (clinical trials) were selected from PubMed, Scopus, Web of Science, and ScienceDirect. Initially, a search was performed in six databases covering public health, medicine, life sciences, and biomedicine (PubMed and ScienceDirect), evidence-based healthcare (Cochrane Library), social sciences, arts, and humanities (Scopus and Web of Science), and research output, with an emphasis on Latin America, Spain, and Portugal. The four databases with the largest number of publications on the older adult population were selected, including topics such as medication adherence (compliance with pharmacological treatment and prescribing recommendations), medication persistence (uninterrupted continuity in medication recovery and administration), and patient prioritization interventions using automated mechanisms. The final selection of articles was carried out by three experts, who performed a critical appraisal of the evidence. The discrepancies were resolved by two other researchers, following the identification, screening, selection and inclusion phases of the PRISMA-2020 guidelines. The analysis of the information was carried out through synthesis and narrative integration.
Individual barriers were identified, including demographic (age, sex, educational level, and income), psychological (anxiety, depression, and self-efficacy), cultural (beliefs, fatalism, and stigmas), physical and mental health status (multimorbidity and cognitive impairment), and pharmacological (number of medications and adverse effects) factors. Facilitators identified are related to the health system (continuity of care, fragmentation of care, assertive communication, access, and provision of medicines). The interventions include personalized health education.
Medication adherence in older adults should be addressed with comprehensive and sustainable interventions. These interventions combine pharmacist education, technological support, continuous monitoring, and patient participation in therapeutic decision-making. Strategies should be designed with a collaborative approach involving patients, families, and healthcare professionals, ensuring measurable clinical outcomes and improving their quality of life.
Authors
Cardona-Arango Cardona-Arango, Santacruz-Restrepo Santacruz-Restrepo, Rendón-Montoya Rendón-Montoya, Madrigal-Cadavid Madrigal-Cadavid, Segura-Cardona Segura-Cardona, Estrada-Acevedo Estrada-Acevedo
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