Medication compliance and older people: a review of the literature

The purpose of this paper is to critically review a select body of literature pertaining to medication compliance among older people. As there is a vast amount of literature on the topic, this review is selective to include (1) a critique of the more commonly cited compliance theories, (2) an analysis of the key variables influencing medication compliance among older people and (3) a critical evaluation of the literature which examines these phenomena. In addition, studies, which explore the benefits of Self-Administration of Medication Schemes, are the subject of particular scrutiny, by virtue of the fact that they address not only the education component but also the behavioural component of a well-organised patient education programme. The review is limited to material published in English since 1980 with the exception of the literature on compliance theories, which originated in previous decades. Key search terms including medication, compliance, older people, self-medication and education were used to derive the relevant material from the Medline and CINAHL databases. The literature was then critically reviewed using the criteria identified by Roe (1993) [Roe, B., 1993. Undertaking a critical review of the literature. Nurse Researcher 1(1), 35-46.] which emphasises the need for clarity in key areas such as research design, sample selection, research methods, results, discussion and conclusions. Empirical research which met this criteria was included in the review and in the main, this was found in academic rather than professional journals. The review concludes with a summary of the main points and a discussion of the implications for nursing practice, education and research. (C) 1999 Elsevier Science Ltd. All rights reserved.