Pharmacist-Led Interventions to Improve Medication Adherence Among Patients with Multimorbidity: A Scoping Review

Background: Patients with multimorbidity tend to have multiple medications or polypharmacy to achieve optimal outcomes, which may result in non-adherence to medication. Medication non-adherence in this population is relatively higher than in patients with a single disease because of more complex medication regimens and greater adverse drug reactions. Providing interventions is an essential solution in changing patients' behavior towards medication adherence among patients with multimorbidity. Pharmacists could help patients achieve optimal outcomes by optimizing medication use, including improving medication adherence. This scoping review aims to identify evidence of the effectiveness and characterize pharmacist-led interventions in improving medication adherence among patients with multimorbidity. Methods: A systematic search was conducted to identify relevant studies on PubMed, Scopus, CENTRAL, and through hand searching. Randomized controlled trial design studies performing interventions to improve medication adherence led by pharmacists among patients living with multimorbidity were included. We focused on original search with the key concepts of "multimorbidity", "pharmacists", and "medication adherence". Narrative synthesis was used to extract and synthesize the data. Results: Twelve studies that included participants with multimorbidity were reviewed. Nine of all twelve studies showed improvement of medication adherence in the intervention group with a p-value <0.05, while three other studies indicated no significant difference between the intervention and control groups. All of the studies employed personalized interventions. Interventions used could be divided into counselling sessions, medication management, or using a supporting tool as a reminder of drug administration. Conclusion: In nine out of twelve studies, interventions led by pharmacists were found to be effective in improving medication adherence in patients with multimorbidity. Effective interventions showed significant improvement in medication adherence in the intervention group compared with the usual care group. These interventions included counselling sessions, medication management, and the use of a supporting tool to remind patients about drug administration.