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Factors associated with medication adherence in older patients: A systematic review

Smaje, A; Weston-Clarke, M; Raj, R; Orlu, M; Davis, DHJ; Rawle, M; (2018) Factors associated with medication adherence in older patients: A systematic review. Aging Medicine , 1 (3) pp. 254-266. 10.1002/agm2.12045. Green open access

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Abstract

OBJECTIVE: Medication adherence is a major challenge in the treatment of older patients; however, they are under‐represented in research. We undertook a systematic review focused on older patients to assess the reasons underlying non‐adherence in this population. METHODS: We searched multiple electronic databases for studies reporting reasons for non‐adherence to medication regimens in patients aged 75 years and over. Our results were not limited to specific diseases, health‐care settings, or geographical locations. The quality of eligible studies was assessed using the Newcastle‐Ottawa Scale. A narrative synthesis of findings was performed. RESULTS: A total of 25 publications were included, all of which were in community settings. Frequent medication review and knowledge regarding the purpose of the medication were positively associated with adherence. Factors associated with poor adherence were multimorbidity, cognitive impairment, complex regimens with multiple prescribing physicians, and problems with drug storage or formulation. CONCLUSION: These findings suggest that interventions to improve adherence could focus on medication review aimed at simplifying regimens and educating patients about their treatment. Groups with poor adherence that may benefit most from such a model include patients with multiple comorbidities and cognitive impairment.

Type: Article
Title: Factors associated with medication adherence in older patients: A systematic review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/agm2.12045
Publisher version: https://doi.org/10.1002/agm2.12045
Language: English
Additional information: © 2018 The Authors. Aging Medicine published by Beijing Hospital and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: drug prescriptions, geriatric medicine, polypharmacy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Pharmaceutics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10062957
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