Medication adherence in the older adults with chronic multimorbidity: a systematic review of qualitative studies on patient’s experience

Maffoni, Marina; Traversoni, Silvia; Costa, Elı́sio; Midão, Luís; Kardas, Przemysław; Kurczewska-Michalak, Marta; Giardini, Anna

doi:10.1007/s41999-020-00313-2

Cited by 39 publications

(24 citation statements)

References 61 publications

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“…Our review covered 13 systematic reviews on medication adherence ( Table A2 ). Seven of them focused on patients with cardiovascular disease or type two diabetes [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ], one on patients with rheumatoid arthritis [ 28 ], one on patients with breast cancer [ 29 ], two on patients with chronic kidney disease or kidney transplants [ 10 , 30 ] and two with no specific illness [ 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research

et al. 2021

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Introduction: Medication adherence continues to be a significant challenge in healthcare, and there is a shortage of effective interventions in this area. This scoping review studied the patient-related factors of medication adherence. Methods: We searched Medline Ovid, Scopus, and Cochrane Library from January 2009 to June 2021 to find the most recent original qualitative studies or systematic reviews that addressed the patient-related factors of medication adherence in treating chronic conditions. We used the PRISMA-ScR checklist to ensure the quality of the study. Results: The initial search revealed 4404 studies, of which we included 89 qualitative studies in the scoping review. We inductively organized the patient-related factors causing barriers, as well as the facilitators to medication adherence. The studies more often dealt with barriers than facilitators. We classified the factors as patient-specific, illness-specific, medication-related, healthcare and system-related, sociocultural, as well as logistical and financial factors. Information and knowledge of diseases and their treatment, communication, trust in patient-provider relationships, support, and adequate resources appeared to be the critical facilitators in medication adherence from the patient perspective. Discussion and conclusions: Patients are willing to discuss their concerns about medications. Better communication and better information on medicines appear to be among the critical factors for patients. The findings of this scoping review may help those who plan further interventions to improve medication adherence.

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Section: Resultsmentioning

confidence: 99%

Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research

et al. 2021

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“…Many of the reported challenges in MM care, were previously reported by HCP [ 57 ] and PCP [ 32 ], predominantly in high income countries. Including, insufficient consultation time [ 58 , 59 ]; issues with depersonalised care and form or level of information provided by HCP [ 59 ]; poorly coordinated or fragmented care [ 58 ]; and limited information exchange between HCP [ 58 , 59 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several improvements were implemented in Brazilian primary health care (PHC), where most MM management takes place [ 29 , 30 ], but its key aspect—treatment adherence—remains vastly under-researched. Only one qualitative study, on medication adherence in hypertensive patients in Brazil [ 31 ], was identified by a recent systematic review [ 32 ]. Addressing this gap in evidence could inform solutions to common problems in management of MM in Brazilian PHC.…”

Section: Introductionmentioning

confidence: 99%

Mental-physical multimorbidity treatment adherence challenges in Brazilian primary care: A qualitative study with patients and their healthcare providers

et al. 2021

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Improved understanding of multimorbidity (MM) treatment adherence in primary health care (PHC) in Brazil is needed to achieve better healthcare and service outcomes. This study explored experiences of healthcare providers (HCP) and primary care patients (PCP) with mental-physical MM treatment adherence. Adults PCP with mental-physical MM and their primary care and community mental health care providers were recruited through maximum variation sampling from nine cities in São Paulo State, Southeast of Brazil. Experiences across quality domains of the Primary Care Assessment Tool-Brazil were explored through semi-structured in-depth interviews with 19 PCP and 62 HCP, conducted between April 2016 and April 2017. Through thematic conent analysis ten meta-themes concerning treatment adherence were developed: 1) variability and accessibility of treatment options available through PHC; 2) importance of coming to terms with a disease for treatment initation; 3) importance of person-centred communication for treatment initiation and maintenance; 4) information sources about received medication; 5) monitoring medication adherence; 6) taking medication unsafely; 7) perceived reasons for medication non-adherence; 8) most challenging health behavior change goals; 9) main motives for initiation or maintenance of treatment; 10) methods deployed to improve treatment adherence. Our analysis has advanced the understanding of complexity inherent to treatment adherence in mental-physical MM and revealed opportunities for improvement and specific solutions to effect adherence in Brazil. Our findings can inform research efforts to transform MM care through optimization.

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“…Medications, including over the counter (OTC) [ 1 ], dietary supplements [ 2 ], and prescription recommended for acute and chronic conditions are the most common treatment option employed in the provision of healthcare [ 3 ]. As medication advances have extended lives and reduced the mortality rate for many diseases, the accompanying prevalence of multimorbidity associated with increasing age creates a scenario in which older adults require complex medication regimens (polypharmacy) to manage their health [ 4 , 5 , 6 ]. The high rates of multimorbidity among older adults in the U.S. [ 7 ], combined with care practices that promote overprescribing rather than prioritize medication monitoring [ 8 ] have made polypharmacy a defining feature of the patient medication experience [ 4 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…As medication advances have extended lives and reduced the mortality rate for many diseases, the accompanying prevalence of multimorbidity associated with increasing age creates a scenario in which older adults require complex medication regimens (polypharmacy) to manage their health [ 4 , 5 , 6 ]. The high rates of multimorbidity among older adults in the U.S. [ 7 ], combined with care practices that promote overprescribing rather than prioritize medication monitoring [ 8 ] have made polypharmacy a defining feature of the patient medication experience [ 4 , 9 ]. Polypharmacy is not without risks and has been associated with increased healthcare costs from drug therapy problems related to sub-optimal medication use [ 10 ], adverse events and lower quality of life [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Revised Home Medication Experience Questionnaire (HOME-Qv2)

2020

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The Home Medication Experience Questionnaire (HOME-Qv2) was developed to identify patient medication experience issues for pharmacist intervention. The study objectives were to (1) evaluate patient responses to the HOME-Qv2 medication experience questionnaire and (2) describe recommendations made by pharmacists in response to the identified medication experience issues and adoption of recommendations. The study sample was comprised of older adults, 55 years and above, who have one or more chronic illnesses for which they routinely take 4+ prescription medications. The HOME-Qv2 was administered to patients and a pharmacist made recommendations based on the responses. At 3 months, the research team followed up with participants via telephone, during which the HOME-Qv2 was again administered and participants shared their adoption of recommendations. Twenty-four patients completed the questionnaire, and twenty-one were available for follow-up. At 3 months, there was a significant decrease in patient self-reported HOME-Qv2 medication experience issues. There were 31 interventions/recommendations provided by the pharmacists, and 64.5% reported adopted. The HOME-Qv2 appears to facilitate patient disclosure of medication experience issues and informed targeted pharmacist recommendations.

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Medication adherence in the older adults with chronic multimorbidity: a systematic review of qualitative studies on patient’s experience

Cited by 39 publications

References 61 publications

Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research

Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research

Mental-physical multimorbidity treatment adherence challenges in Brazilian primary care: A qualitative study with patients and their healthcare providers

Evaluation of a Revised Home Medication Experience Questionnaire (HOME-Qv2)

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