Healthcare professionals' perspectives on medication adherence-supporting tools: a cross‑sectional survey in Italy

Medication adherence is essential for treatment effectiveness, yet the uptake of adherence-supporting tools in routine care remains suboptimal. This study assessed Italian healthcare professionals' knowledge, perceived utility, and willingness to recommend medication adherence tools, and explored perceived barriers to their adoption.

A questionnaire targeting healthcare professionals working in inpatient or outpatient settings across Italy was developed and validated by a panel of seven experts. It was anonymously distributed online between October and December 2023 to physicians, pharmacists, and nurses. The survey included open-ended and Likert-scale questions investigating use, perceived usefulness, barriers, and future willingness to recommend specific medication adherence tools. Data were analyzed using descriptive statistics, and differences by professional category were evaluated using Chi-square or Fisher's exact tests. Open-ended responses were analyzed through a multi-step conventional content analysis independently conducted by two researchers.

A total of 660 healthcare professionals participated, including pharmacists (35%), nurses (26%), general practitioners (22%), geriatricians or internists (8.6%), and other medical doctors (8.5%). Overall, knowledge and recommendation regarding medication adherence tools were limited, with awareness ranging from 40.0% to 94.7% depending on the tool. Traditional tools such as pillboxes and paper diaries were more frequently used (42.1% and 26.3%, respectively) and were perceived as useful (26.7% and 22.3%). In contrast, digital tools (e.g., mobile apps, SMS reminders, electronic pillboxes) were rarely recommended and often described as unfamiliar. Patient-related barriers emerged as the most commonly reported obstacles for both traditional and digital tools.

Italian healthcare professionals show limited familiarity with and use of medication adherence tools, particularly digital solutions. Targeted training and system-level strategies are needed to increase awareness, address perceived barriers, and promote the integration of effective adherence-supporting tools into routine care.