Literature Review: Determinants and Interventions for Optimizing Medication Adherence

Abstract

This literature review synthesizes recent evidence on the determinants of medication adherence and the interventions most likely to improve it in chronic care. Using the initiation–implementation–persistence framework, it organizes barriers and facilitators across four levels: patient factors (health literacy, beliefs, motivation, mental health), therapy factors (polypharmacy, side effects, dosing complexity), provider factors (communication, shared decisions, follow-up), and system factors (cost, access, continuity, and fragmented services). The review compares intervention approaches, including tailored education, regimen simplification, motivational interviewing, pharmacist-led monitoring, multidisciplinary care pathways, and financial or logistical support. Particular attention is given to digital strategies—SMS reminders, mobile apps, telehealth, electronic refill prompts, and smart packaging—and the conditions under which they succeed or fail. Findings indicate that single, generic interventions rarely sustain adherence; combined, patient-centered and context-sensitive packages perform better, especially when aligned with local resources at Maaref University of Applied Sciences and similar settings, and evaluated with pragmatic outcomes and equity.