title: Interventional tools to improve medication adherence: review of literature.
abstract: Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons.
authors.affiliation: UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, Porto, Portugal.
authors.forename: Elísio
authors.initials: E
authors.lastname: Costa
authors.affiliation: Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Montescano (PV), Pavia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Giardini
authors.affiliation: European Association of Pharmaceutical Full-line Wholesalers, Brussels, Belgium.
authors.forename: Magda
authors.initials: M
authors.lastname: Savin
authors.affiliation: CIRFF/Center of Pharmacoeconomics, School of Pharmacy, University of Naples FedericoII, Nápoles, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Menditto
authors.affiliation: Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland.
authors.forename: Elaine
authors.initials: E
authors.lastname: Lehane
authors.affiliation: Centro de Investigación Clínica del Anciano Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Laosa
authors.affiliation: Italian Medicines Agency - AIFA, Rome, Italy ; University of Brescia, Brescia, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Pecorelli
authors.affiliation: Italian Medicines Agency - AIFA, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Monaco
authors.affiliation: Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
keywords: chronic diseases; cognitive impairment; compliance; elderly; nonadherence; tools