Sleep quality significantly impacts individuals’ overall health, especially in older adults. Older adults often face comorbid conditions, polypharmacy (the intake of five or more medications per day), and medication non-adherence, which are common among those with sleep disorders. The purpose of this systematic review is to examine the relationship between sleep quality and medication adherence in older adults and to describe the measuring instruments used. A systematic review was performed following the PRISMA guidelines. The PubMed, Scopus, Cochrane Library, and CINAHL databases were screened from January 2024 to March 2024. Nine articles were included in the final synthesis based on the inclusion and exclusion criteria. The review found that poor sleep quality is significantly associated with reduced medication adherence in older adults. The key sleep determinants linked to medication non-adherence include sleep disorders, sleep efficiency, sleep duration, and daytime dysfunctions. Inappropriate medication prescriptions have been associated with reduced sleep efficiency. The tools for assessing sleep quality and medication adherence are predominantly subjective and varied. To address these challenges, a comprehensive geriatric assessment should include investigations into sleep disorders and comorbidity factors. Additionally, nursing educational interventions could be pivotal in improving medication adherence among older adults.
Background: Demographic, social, and familial changes have led to an increase in the lack of family and support systems, which is particularly relevant for older adults who may be at risk for low medication adherence. This study examines the relationship between social isolation and/or loneliness and medication adherence in older adults, also identifying the measurement tools used to explore this relationship. Methods: We conducted a systematic review according to PRISMA guidelines, searching databases including PubMed, CINAHL, PsycINFO, and EBSCO. The quality of evidence was assessed following the GRADE approach, integrated with the JBI Critical Appraisal Tools, NOS for cohort studies and AXIS tools. Results: In the final synthesis, we included five articles. According to the findings of the study, social isolation and loneliness may negatively affect medication adherence in older adults. Loneliness and social support may have a mediating role in the relationship between social isolation and medication adherence. Conclusions: Loneliness and social isolation could influence medication adherence in older patients, especially in managing chronic conditions, but more robust research is needed to confirm the associations between social isolation, loneliness, and medication adherence. However, addressing loneliness and social isolation may be critical to improving medication management among older adults.
Background: In older adults, multimorbidity and polypharmacy complicate medication regimens and often lead to poor adherence. Mobile health (mHealth) has been suggested as a solution to enhance medication adherence in chronic conditions. Despite the increase in smartphone usage among people aged 65 and over, there is still a lack of evidence of mHealth in this age group. Objectives: To evaluate the impact of mHealth interventions on medication adherence in older adults (≥65 years) with chronic diseases, compared with standard care or other interventions. Methods: The review was conducted in accordance with PRISMA 2020 guidelines and the Cochrane Handbook for Systematic Reviews. Randomized controlled trials published from 2000 onwards were considered with no linguistic or geographical restrictions. The databases searched included PubMed, Scopus, Cochrane Library, and CINAHL. Methodological quality was assessed using the Revised Cochrane Risk of Bias Tool for Randomized Trials. Results: 551 records were initially identified, from which 8 randomized controlled trials published between 2014 and 2025 were included. Six of eight studies showed that medication adherence in mHealth groups was significantly higher than in controls. However, one study found benefits only in specific drug classes rather than a general improvement. Conclusions: The results of this review suggest that mHealth has the potential to improve medication adherence among older adults with chronic diseases, especially when interventions go beyond simple reminders and incorporate educational and relational components. Nevertheless, higher quality studies with larger samples and longer follow-up are needed to clarify mHealth’s role in the care of this population.
Objectives: This study aims to identify factors associated with medication errors among home care nurses in Italy, focusing on the relationships between knowledge, attitudes, and behaviors, and assessing how sociodemographic and professional characteristics influence these dimensions. Methods: A nationwide cross-sectional survey was conducted using the Italian validated version of the Knowledge, Attitudes, and Behaviors in Medication Error in the Home Care setting questionnaire, previously developed and validated for home care settings. Multivariate logistic regression analyses were performed to explore associations among knowledge, attitudes, behaviors, and selected sociodemographic variables because the survey was disseminated through open online channels, and the response rate could not be calculated. Results: A total of 320 nurses participated. Younger age and holding a non-university degree were significantly associated with higher knowledge levels. Internet access at the workplace emerged as the only significant factor associated with medication error prevention for both positive attitudes [OR = 0.412, 95% CI: 0.197–0.861; p = 0.018] and correct behaviors [OR = 0.456, 95% CI: 0.216–0.962; p = 0.039]. Furthermore, attitudes positively predicted knowledge [OR = 2.226, 95% CI: 1.291–3.962, p = 0.004], and both knowledge and attitudes significantly influenced behaviors. Conclusions: The study highlights the interdependence of knowledge, attitudes, and behaviors in preventing medication errors in home care. While internet access and formal education are associated with differences in knowledge, attitudes, and behaviors, the relationships observed warrant further investigation. These findings underscore the potential value of targeted educational strategies and resource availability to support nurses in promoting safe practices.
Background: Treatment Burden (TB) refers to the workload imposed on patients by healthcare-related tasks involved in the management of chronic conditions. Despite increasing evidence on this phenomenon, strategies for its reduction in older adults with multimorbidity remain poorly explored. Aim: To map the factors associated with treatment burden reported for older patients with multimorbidity and to derive implications for potential reduction strategies, regardless of the care setting. Methods: A scoping review was conducted applying the JBI methodology for scoping reviews and reported in accordance with the PRISMA-ScR checklist. The literature search was performed on PubMed, Scopus, and CINAHL; no restrictions on publication year or language were applied. All study designs were eligible if they reported factors associated with TB from which reduction strategies could be derived, in patients aged ≥65 years, or with a mean age ≥ 65 years, with multimorbidity or associated geriatric conditions. Results: Six studies met the eligibility criteria, all of which were observational in design, conducted between 2021 and 2025. Eleven potential strategies for TB reduction, inferred from observational findings, were identified and grouped into three areas: healthcare system and access to care, therapeutic regimen, and patient and psychosocial context. Conclusions: To our knowledge, this review provides the first structured mapping of potential TB reduction strategies specifically in the older population with multimorbidity. The identified strategies, derived by the authors rather than empirically tested, may exclusively inform the design of future interventional studies and offer healthcare professionals preliminary guidance for TB management in this population.