A conceptual framework to study medication adherence in older adults
Abstract
Background Adults aged > or =50 years often have multiple chronic diseases requiring multiple medications. However, even drugs with well-documented benefits are often not taken as prescribed, for a variety of reasons. Objective The objective of this article was to provide background information about medication adherence and its measurement, the development of the conceptual model for use in adherence research, and supportive intervention strategies such as pharmaceutical care by pharmacists to improve chronic medication use in older adults. Methods English-language literature published from 1990 to 2000 was searched on MEDLINE, International Pharmaceutical Abstracts, and AARP Ageline using the terms aged, heart failure, CHF, adherence, chronic heart failure, compliance, and related terms. The authors used their personal files and libraries to obtain seminal literature and textbooks published before 1990. Results Although the cognitive processes needed to manage and take medications decline with aging, the number of prescription and nonprescription medications consumed increases. Other factors such as vision, hearing, health literacy, disability, and social and financial resources may all complicate the ability of older adults to adhere to the pharmacologic prescription. Conclusions Many factors are associated with medication adherence and related health outcomes in older adults. Therefore, strategies to improve adherence will need to be multidimensional, including improvements in pharmacy services that consider age-related factors (eg, declining cognitive and physical functions) as well as a variety of environmental and social factors.
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Many conceptual models have been developed to help understand the factors contributing to medication adherence in specific patient groups and/or for specific disease conditions.
“Many conceptual models have been developed to help understand the factors contributing to medication adherence in specific patient groups and/or for specific disease conditions.10–12”
From An Adaptable Framework for Factors Contributing to Medication Adherence: Results from a Systematic Review of 102 Conceptual Frameworks (2021) · cites this paper as [10]
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- Authors
- MURRAY, M.
- Affiliations
- Regenstrief Institute (US)
- Corresponding author
- MURRAY, M
- ORCID
- MURRAY, M
- Venue
- The American Journal of Geriatric Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 2
- Issue
- 1
- Pages
- 36-43
- ISSN
- 1543-5946 (ISSN-L)
- OpenAlex
- W1985265935
- Cited by
- 222
- References
- 68
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 9 · 2023: 5 · 2022: 9 · 2021: 5 · 2020: 14 · 2019: 8 · 2018: 9 · 2017: 15 · 2016: 13 · 2015: 13 · 2014: 19 · 2013: 13 · 2012: 15
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Geriatric Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG007631, R01AG019105)
- National Heart, Lung, and Blood Institute (R01HL069399)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- medication adherence, older adults, chronic heart failure, polypharmacy, pharmaceutical care, pharmacists, conceptual model, health literacy, cognitive decline, adherence measurement
- MeSH terms
- Aged, Aging, Drug Therapy, Nonprescription Drugs, Heart Failure, Humans, Middle Aged, Patient Compliance, Pharmaceutical Services, Drug Prescriptions, Socioeconomic Factors, Outcome Assessment, Health Care
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