Medication Adherence Interventions for Older Adults: A National Mixed‐Methods Study of Implementation Across Italian Healthcare Settings
Sara Mucherino, Luca Pasina, Manuela Casula, Monia Donati, Carlotta Lunghi, Elena Olmastroni, Valentina Orlando, Emanuel Raschi, Stefano Scotti, Marco Salluzzo, Elisabetta Poluzzi, Alessandro Nobili, Enrica MendittoABSTRACT
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.