The number of older travellers continues to increase internationally. Consequently, physicians are frequently confronted with situations relating to travelling of older people with multiple chronic morbidities and taking multiple medications. The risk of travel-related diseases is more than 2-fold in people with underlying medical conditions in comparison to healthy travellers. Although many guidelines on travelling with a particular chronic disease exist so far, it can be a challenge to tailor these considerations to an individual with multimorbidity. It is important that the health needs and potential vulnerability of the older traveller are recognized by physicians and patients alike. Educating patients on this topic could provide a significant benefit – helping them to enjoy their travel by being well prepared.@en

Poor adherence to treatment regimens has long been recognized as a substantial roadblock to achieving better outcomes for patients. Non-adherence to medications affects the quality and length of life and has been associated with negative health outcomes and increasing healthcare costs. The problem of non-adherence is particularly troublesome in older patients who are affected by multiple chronic diseases and for this reason receive multiple treatments. To date, no single intervention strategy has been shown to be effective in improving adherence across all patients, conditions, and settings. Between September and October 2014, a group of experts in geriatrics, pharmacology, epidemiology, and public health applied a modified RAND appropriateness method to reach a consensus on the possible best interventions to improve adherence in older individuals. Seven interventions were identified, classified based on their target (patient, therapy,
and public health/society): (1) Comprehensive Geriatric Assessment, (2) patient (and caregiver) education to improve patient empowerment, (3) optimization of treatment, (4) use of adherence aids, (5) physician and other
healthcare professionals’ education, (6) adherence assessment, (7) facilitating access to medicine by service integration. For each intervention, experts assessed (a) target population, (b) health professionals potentially involved in
the intervention, (c) strategies/instruments needed for implementation, and (d) time of the intervention. Interventions that target adherence must combine different approaches targeting the complex aspects of older adults in
a holistic approach. Tackling non-adherence, with its complexity, requires a multi-stakeholder patient-centred approach acting in a defined framework of interactions in which the different players may provide different services
but are integrated with one another.@en