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

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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.

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Author information

Authors and Affiliations

  1. School of Pharmacy, University of Washington, Seattle, WA, USA

    Zachary A. Marcum

  2. Schools of Medicine (Geriatrics), Pharmacy, and Public Health, University of Pittsburgh, 3471 Fifth Avenue, Suite #500, Pittsburgh, PA, 15213, USA

    Joseph T. Hanlon

  3. Center for Health Equity Research and Promotion and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Joseph T. Hanlon

  4. Purdue University College of Pharmacy and Regenstrief Institute, Indianapolis, IN, USA

    Michael D. Murray

Authors
  1. Zachary A. Marcum
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  2. Joseph T. Hanlon
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  3. Michael D. Murray
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Corresponding author

Correspondence to Joseph T. Hanlon.

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Funding

Dr. Marcum is supported by funding from the Agency for Healthcare Research and Quality (AHRQ) (K12HS022982). Dr. Hanlon is supported by funding from National Institutes of Health (NIH)/National Institute on Aging (NIA) (P30AG024827, T32AG021885, U13AG047008) and AHRQ (R18HS023779). Dr. Murray is supported by funding from an endowment on medication safety from Purdue University (Indianapolis, IN, USA) and the Regenstrief Foundation.

Conflict of interest

The authors have no conflicts of interest, including financial interests, activities, relationships or affiliations, relevant to this study.

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Marcum, Z.A., Hanlon, J.T. & Murray, M.D. Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials. Drugs Aging 34, 191–201 (2017). https://doi.org/10.1007/s40266-016-0433-7

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  • DOI: https://doi.org/10.1007/s40266-016-0433-7

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