Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials.

Marcum ZA1, Hanlon JT2,3, Murray MD4.

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Abstract

BACKGROUND:

Poor medication adherence is a major public health problem in older adults often resulting in negative health outcomes.

OBJECTIVE:

The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings.

METHODS:

Articles that assessed medication adherence interventions and related health outcomes in elderly individuals were identified through searches of MEDLINE (1970-June 2016), the Cochrane Database of Systematic Reviews (through to June 2016), and Google Scholar. Across the 12 included studies, interventions were grouped into three main categories: behavioral/educational (n = 3), pharmacist-led (n = 7), and reminder/simplification (n = 2).

RESULTS:

Among the behavioral/educational intervention studies, two showed improvements in both adherence and related health outcomes, whereas one found no changes in adherence or health outcomes. Among the pharmacist-led studies, three showed improvements in both adherence and related health outcomes, while three reported no changes in adherence or health outcomes. One found an improvement in adherence but not health outcomes. Among the reminder/simplification studies, both studies reported improvements in adherence without a significant impact on related health outcomes.

CONCLUSION:

This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature. Future patient-centered and multidisciplinary interventions should be developed and tested using evidence-based principles to improve medication adherence and health outcomes in older adults.