Enhancing Medication Adherence in Older Adults: A Systematic Review of Evidence‐Based Strategies

Background Medication adherence is essential for achieving favorable health outcomes, particularly in older adults with multiple chronic conditions. Objective This systematic review critically appraised current evidence on interventions aimed at enhancing medication adherence in older adults. Methods Literature searches were performed in PubMed/MedLine, EMBASE, and Web of Science for articles published up to December 31, 2024. We identified peer-reviewed studies assessing interventions to improve medication adherence in older adults (≥ 60 years). The primary outcome was intervention effectiveness; secondary outcomes were clinical parameters, disease control, health-related quality of life, rehospitalization rates, event rates, mortality rates, feasibility, acceptability or satisfaction levels, and overall costs or cost-effectiveness. Results A total of 128 studies was included: 96 randomized controlled trials (RCTs), 16 pre–post studies, 9 non-RCTs, and 7 longitudinal evaluations. The majority (51.2%) was implemented in primary care. An educational component was present in 56.3% of interventions, a technical component in 47.6%, and an attitudinal component in 32.0%. Only 3.2% of interventions included rewards. Various healthcare professionals, such as pharmacists, nurses, and physicians, were involved in delivering interventions. Most studies reported improved adherence, though some factors, such as high baseline adherence, insufficient intervention intensity, and brief follow-up limited the effectiveness. Secondary outcomes often included improvements in disease knowledge, patient satisfaction, quality of life, and clinical indicators like blood pressure and HbA1c levels. Conclusions Despite most studies showed a positive impact on adherence, a high heterogeneity was highlighted, and effectiveness was mainly observed in the short term.