Strategies to Improve Medication Adherence in Older Persons

Consensus Statement from the Senior Italia Federanziani Advisory Board

Journal article (2016)

Authors

A. Marengoni University of Brescia
A. Monaco Italian Medicines Agency
S. Pecorelli University of Brescia
G Onder Universita Cattolica del Sacro Cuore
E. Costa Universidade do Porto
A. Cherubini IRCCS-INRCA
A Prados-Torres Aragon Health Sciences Institute (IACS)
C. Muth Goethe University
R.J.F. Melis Radboud Universiteit Nijmegen
L. Pasina IRCCS-Istituto di Ricerche Farmacologiche ‘‘Mario Negri’’
Tischa J.M. van der Cammen Applied Ergonomics and Design - IDE , Erasmus Medical Centre
TJM van der Cammen Applied Ergonomics and Design - IDE , Erasmus Medical Centre
T.J.M. van der Cammen Applied Ergonomics and Design - IDE , Erasmus Medical Centre
Tischa van der Cammen Applied Ergonomics and Design - IDE , Erasmus Medical Centre
K. Palmer San Camillo IRCCS
Research Group
Applied Ergonomics and Design (IDE) (TU Delft)
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Published Date

2016

Language

English

Reuse Rights

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Faculty

Industrial Design Engineering

Department

Human-Centered Design

Research Group

Applied Ergonomics and Design

Abstract

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.