Older people and adherence with medication: A review of the literature

Background: Older people represent a sizeable population of the UK. Many older people receive drug treatment for long-term conditions. Adherence with medication is therefore an important clinical, financial and resource intensive concern. Objectives: This review aimed to examine patient's beliefs, perceptions and views in relation to adherence with medication. Design: A comprehensive search of the literature was undertaken using numerous approaches. The search of revealed 30 research papers. Findings: Articles were initially evaluated using Critical Appraisal Skills Programme principles to identify those relevant to the review. Relevant studies were then subjected to a narrative analysis to assist the development of relevant themes. Four themes were identified; experience of adherence; perceptions and attitudes to medication adherence and non-adherence; patients acceptance of their illness and impact on medication taking behaviour and shared decision making. Conclusions: The findings of this review imply that there is a need for more emphasis on shared decision making between the older patient and the prescriber. Using this approach, adherence with medication may improve. There is also a need to develop a standardized measure of medication adherence. (C) 2008 Elsevier Ltd. All rights reserved.