New medicines services, more counselling when a medicine is supplied again, dosage administration aids and reminder systems are among a list of pharmacy interventions with evidence of improving adherence to medication in elderly patients with chronic conditions, according to new a report from the International Pharmaceutical Federation (FIP). 

The authors of the report, “Use of medicines by the elderly: The role of pharmacy in promoting adherence”, reviewed existing knowledge of pharmacy programmes and services to improve adherence in this growing patient population. “Pharmacists have a key role in monitoring and improving patient adherence to medicines, both as a single profession, as well as within a multidisciplinary, patient-centred collaborative team,” said Parisa Aslani, lead author of the report and professor in medicines use optimisation at The University of Sydney School of Pharmacy.

Elderly patients are at particular risk of non-adherence because they often take several medicines for multiple conditions, and taking these medicines properly can be a challenge, especially for those with declining cognitive function, or mobility and manual dexterity issues.

The authors also point out that mild or early cognitive decline can go unnoticed by health professionals. They recommend that pharmacists be given training to prevent them from missing signs of cognitive impairment, allowing them to adjust the way in which they communicate with patients and the actions they take.

“Medication regimens should be convenient and, as far as possible, undemanding. It is important to develop and implement interventions that address the individual needs of patients. And these interventions must have long-term sustainability,” said Aslan.

According to the report, although a large body of evidence exists for a wide range of interventions, there is no consolidated set of solutions to optimise adherence to medication. However, given the number of potential intervention points from diagnosis through to the dispensing and taking of a medicine, the authors did find that multiple interventions have a relatively greater effect than single interventions. 

Although the report is focused on adherence in the elderly, most of the interventions found to be effective can be applied to patients of all ages, the authors say. The report is intended as a tool to promote the role pharmacists can play in tackling adherence issues to governments and other agencies.

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