Medication Adherence Interventions for Older Adults: A National Mixed‐Methods Study of Implementation Across Italian Healthcare Settings
8 affiliations
- 1Department of Pharmacy University of Naples Federico II Naples Italy
- 2Center of Pharmacoeconomics and Drug Utilization Research (CIRFF) University of Naples Federico II Naples Italy
- 3Health Policies Research Department, Laboratory of Clinical Pharmacology and Appropriateness of Drug Prescription Istituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
- 4Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- 5IRCCS MultiMedica Sesto San Giovanni Italy
- 6Department of Medical and Surgical Sciences University of Bologna Bologna Italy
- 7Population Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec‐Université Laval Québec City Canada
- 8Department of Life Sciences, Health and Health Professions Link Campus University Rome Italy
Abstract
Background: Medication non‐adherence is common among older adults and represents a major challenge for healthcare systems. Effective interventions are needed to support adherence and inform quality‐improvement efforts.
Objective: To assess how medication‐adherence interventions for older adults are currently implemented in Italy and to identify care‐delivery priorities improving quality and feasibility across healthcare settings.
Methods: We conducted a mixed‐methods study within the Eldercare project. We administered a national benchmarking survey (May–August 2024) to healthcare professionals and patient representatives from scientific societies, professional orders, public institutions, universities, and patient associations. We ran a nested Strengths, Weaknesses, Opportunities and Threats (SWOT) survey (January–March 2025) with key informants. We summarized quantitative responses, compared distributions across professional roles (χ 2/Fisher's exact tests), and analyzed SWOT free‐text using a hybrid deductive–inductive Framework Method.
Results: In the benchmarking survey (n = 340), Respondents reported that adherence is mainly addressed during routine consultations (78.5%) and most often relied on direct patient‐provider communication (51.5%). Respondents reported that monitoring is primarily based on clinical data (55.3%) and access to dispensing/prescription data and digital tools was less frequent (generally ≤ 50%). Respondents rated patient‐centered strategies as highly important (e.g., caregiver involvement 94.4%, shared goal setting 90.3%, individual counseling 87.6%), but feasibility ratings were consistently lower. The most frequently reported unmet needs were limited patient awareness (68.8%) and poor coordination among professionals (60.3%). Key barriers included high numbers of daily medicines (69.1%) and lack of clear information on prescribed therapies (64.7%). In the SWOT survey (n = 14), strengths included continuity and communication, while weaknesses and threats focused on fragmented interprofessional collaboration, limited training, low digitalisation, and scarce financial/institutional support.
Conclusions: Medication‐adherence support for older adults in Italy remains largely consultation‐based and variably resourced. Strengthening interprofessional coordination, training, and use of digital/administrative data may help develop more structured and scalable adherence‐support pathways as a quality‐improvement model of care.
Related
- Adapting an Interprofessional Medication Adherence Program for Gout (IMAP-Gout): A Theory-Informed Pre-Implementation Analysis Using the Theoretical Domains Framework (TDF).
- Medication Adherence in Patients With Glaucoma and Determinants of Treatment Adherence: A Cross-Sectional Study
- Process evaluation of the INTENSE study aimed at improving adherence to oral diabetes and/or hypertension medication in people with type 2 diabetes
- Effectiveness of a pharmacy-led personalised intervention program aimed at improving adherence to oral diabetes and/or hypertension medication in people with type 2 diabetes
- The widening medication adherence gap
BibTeX
@article{mucherino2026medication,
title = {{Medication Adherence Interventions for Older Adults: A National Mixed‐Methods Study of Implementation Across Italian Healthcare Settings}},
author = {Sara Mucherino and Luca Pasina and Manuela Casula and Monia Donati and Carlotta Lunghi and Elena Olmastroni and Valentina Orlando and Emanuel Raschi and Stefano Scotti and Marco Salluzzo and Elisabetta Poluzzi and Alessandro Nobili and Enrica Menditto},
journal = {Journal of the American Geriatrics Society},
year = {2026},
month = aug,
doi = {10.1111/jgs.70596},
url = {https://doi.org/10.1111/jgs.70596},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Medication Adherence Interventions for Older Adults: A National Mixed‐Methods Study of Implementation Across Italian Healthcare Settings
AU - Sara Mucherino
AU - Luca Pasina
AU - Manuela Casula
AU - Monia Donati
AU - Carlotta Lunghi
AU - Elena Olmastroni
AU - Valentina Orlando
AU - Emanuel Raschi
AU - Stefano Scotti
AU - Marco Salluzzo
AU - Elisabetta Poluzzi
AU - Alessandro Nobili
AU - Enrica Menditto
PY - 2026
DA - 2026/08/03
JO - Journal of the American Geriatrics Society
DO - 10.1111/jgs.70596
UR - https://doi.org/10.1111/jgs.70596
AB - Background: Medication non‐adherence is common among older adults and represents a major challenge for healthcare systems. Effective interventions are needed to support adherence and inform quality‐improvement efforts. Objective: To assess how medication‐adherence interventions for older adults are currently implemented in Italy and to identify care‐delivery priorities improving quality and feasibility across healthcare settings. Methods: We conducted a mixed‐methods study within the Eldercare project. We administered a national benchmarking survey (May–August 2024) to healthcare professionals and patient representatives from scientific societies, professional orders, public institutions, universities, and patient associations. We ran a nested Strengths, Weaknesses, Opportunities and Threats (SWOT) survey (January–March 2025) with key informants. We summarized quantitative responses, compared distributions across professional roles (χ 2/Fisher's exact tests), and analyzed SWOT free‐text using a hybrid deductive–inductive Framework Method. Results: In the benchmarking survey (n = 340), Respondents reported that adherence is mainly addressed during routine consultations (78.5%) and most often relied on direct patient‐provider communication (51.5%). Respondents reported that monitoring is primarily based on clinical data (55.3%) and access to dispensing/prescription data and digital tools was less frequent (generally ≤ 50%). Respondents rated patient‐centered strategies as highly important (e.g., caregiver involvement 94.4%, shared goal setting 90.3%, individual counseling 87.6%), but feasibility ratings were consistently lower. The most frequently reported unmet needs were limited patient awareness (68.8%) and poor coordination among professionals (60.3%). Key barriers included high numbers of daily medicines (69.1%) and lack of clear information on prescribed therapies (64.7%). In the SWOT survey (n = 14), strengths included continuity and communication, while weaknesses and threats focused on fragmented interprofessional collaboration, limited training, low digitalisation, and scarce financial/institutional support. Conclusions: Medication‐adherence support for older adults in Italy remains largely consultation‐based and variably resourced. Strengthening interprofessional coordination, training, and use of digital/administrative data may help develop more structured and scalable adherence‐support pathways as a quality‐improvement model of care.
SN - 0002-8614
SN - 1532-5415
ER -