Digital Health Interventions to Improve Medication Adherence Among Older Adults: A Systematic Review

Area of Science:

• Gerontology
• Digital Health
• Pharmacology

Background:

• Medication adherence is critical for older adults' health outcomes.
• Digital health interventions (DHIs) offer novel approaches to support medication adherence.
• Evidence on the effectiveness of various DHIs in older populations requires synthesis.

Purpose of the Study:

• To systematically review the evidence on digital health interventions for medication adherence in older adults.
• To characterize the types, features, and effects of DHIs on medication adherence in individuals aged 65 years and older.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, CINAHL, Scopus, Web of Science) up to May 2025.
• Included randomized and non-randomized studies focusing on older adults (≥65 years) using DHIs for medication adherence.
• Risk of bias and certainty of evidence were assessed using Cochrane tools and GRADE, followed by narrative synthesis.

Main Results:

• 35 articles were included, predominantly randomized controlled trials (n=22).
• 17 studies reported improved medication adherence with DHIs compared to control or baseline.
• Mobile apps, electronic reminders, social assistive robots, telenursing, and combined DHIs showed positive results, particularly those with multiple behavior-change strategies.

Conclusions:

• Digital health interventions, especially those with tailored reminders, multicomponent features, and interactivity, show potential for improving medication adherence in older adults.
• Variability in DHI effectiveness highlights the need for further research into usage patterns and underlying factors.
• Future research should focus on optimizing DHI design and implementation for sustained medication adherence in geriatric populations.