V. 4 N. 3 (2025): learning self-care
Articles

Impact of Medication Adherence and Quality of Life in Adults With a Single Chronic Condition or Multimorbidity: A Narrative Review

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  • Stefano Likaj,
  • Brunilda Subashi,
  • Erlini Kokalla,
  • Emirjona Kicaj,
  • Enkeleint A. Mechili
Stefano Likaj
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
Brunilda Subashi
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Scientific Research Center for Public Health, Faculty of Health, University of Vlora “Ismail Qemali”, Vlore, Albania
Erlini Kokalla
Department of Statistical Sciences, Sapienza University of Rome, Italy; Faculty of Medicine, Transilvania University, Brasov, Romania
Emirjona Kicaj
Faculty of Medicine, Transilvania University, Brasov, Romania; Department of Healthcare, Faculty of Health, University of Vlora, Albania
Enkeleint A. Mechili
School of Medicine, University of Crete, Heraklion, Greece
DOI: https://doi.org/10.36253/if-3562

Pubblicato 2025-09-30

Parole chiave

  • Medication Adherence,
  • Quality of Life,
  • Chronic Disease,
  • Multimorbidity

Copyright (c) 2025 Stefano Likaj, Brunilda Subashi, Erlini Kokalla, Emirjona Kicaj, Enkeleint A. Mechili

Creative Commons License

TQuesto lavoro è fornito con la licenza Creative Commons Attribuzione 4.0 Internazionale.

Abstract

Introduction. Medication adherence plays a critical role in the clinical management of chronic conditions and may significantly influence patients' quality of life (QoL). Understanding this relationship is particularly important in populations with multimorbidity. Focusing on the problem of chronic conditions and multimorbidity in young adults is crucial because they represent the active part of society and chronicity is now public health concern due to the high number of incidence and mortality among this group population.

Methods. An extensive literature search was conducted in the PubMed/MEDLINE, Scopus, and Web of Science databases for the period 2014–2024. The search strategy used both Medical Subject Headings (MeSH) and keywords related to medication adherence, quality of life, chronic conditions, and adult populations. Original, full-text articles published in English between 2014 and 2024 were included if they involved adults aged 18–65 with one or more chronic conditions (e.g., diabetes, hypertension, COPD), living in community settings. Eligible studies employed RCTs, cohort, cross-sectional, case-control, qualitative, or mixed-methods designs and reported on both medication adherence and quality of life. Studies were excluded if they focused on psychiatric, oncologic, surgical, transplant, or dialysis populations, hospital-based settings, or lacked relevant adherence and quality of life outcomes. This review is in PROSPERO with code CRD42025641905

Results. Eleven studies were included, cross-sectional, randomized control trial, mixed methods, semi directive interview. Most studies demonstrated a positive association between medication adherence and quality of life, with higher adherence linked to better physical, psychological, and social well-being. Pharmacist-led interventions and digital tools emerged as effective strategies for improving adherence. However, heterogeneity in measurement tools and study populations limited comparability.

Discussion. Medication adherence is a key modifiable factor influencing quality of life among individuals with chronic conditions and multimorbidity. Multidimensional adherence-enhancing strategies—including education, patient empowerment, and system-level changes—are essential. Future research should adopt robust methodologies and standardized outcome measures to better inform clinical practice and policy.

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Riferimenti bibliografici

  1. World Health Organization. Noncommunicable diseases. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
  2. Centers for Disease Control and Prevention. About chronic diseases. 2023. Available from: https://www.cdc.gov/chronicdisease/about/index.htm
  3. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: Toward a more uniform methodology. Ann Fam Med. 2012;10(2):142–51. https://doi.org/10.1370/afm.1337
  4. Bayliss EA, Ellis JL, Steiner JF. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Ann Fam Med. 2007;5(5):395–402. https://doi.org/10.1370/afm.722
  5. Brown MT, Bussell J, Dutta S, Davis K, Strong S, Mathew S. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86(4):304–14. https://doi.org/10.4065/mcp.2010.0575
  6. World Health Organization. Adherence to long-term therapies: Evidence for action. Geneva: WHO; 2003. Available from: https://apps.who.int/iris/handle/10665/42682
  7. Mendys P, Zullig LL, Burkholder R, Granger BB, Bosworth HB. Medication adherence: Process for implementation. Patient Prefer Adherence. 2014;8:1025–34. https://doi.org/10.2147/PPA.S65041
  8. Prinsen CAC, Vreman RA, Mokkink LB, van Dijk L. Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: A systematic review and meta-analysis. Syst Rev. 2023;12(1):18. https://doi.org/10.1186/s13643-023-02340-z
  9. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89. https://doi.org/10.1186/s13643-021-01626-4
  10. Babateen O, Aldharman SS, Mogharbel G, Badawi AS, Aljohani SA, Alsharif MM, Al-Jallal MS, Samkari JA. Medication adherence status and its association with quality of life among individuals with neurological conditions in Saudi Arabia. Cureus. 2023;15(6):e40508. https://doi.org/10.7759/cureus.40508
  11. Ahmed S, Saif-Ur-Rahman KM, Dhungana RR, Ganbaatar G, Ashraf F, Yano Y, et al. Medication adherence and health-related quality of life among people with diabetes in Bangladesh: A cross-sectional study. Endocrinol Diabetes Metab. 2023;6(5):e444. https://doi.org/10.1002/edm2.444
  12. Kołtuniuk A, Pytel A, Krówczyńska D, Chojdak-Łukasiewicz J. The quality of life and medication adherence in patients with multiple sclerosis—Cross-sectional study. Int J Environ Res Public Health. 2022;19(21):14549. https://doi.org/10.3390/ijerph192114549
  13. Tusa BS, Geremew BM, Tefera MA. Health related quality of life and associated factors among adults with and without diabetes in Adama city East Shewa, Ethiopia 2019; using generalized structural equation modeling. Health Qual Life Outcomes. 2020;18(1):83. https://doi.org/10.1186/s12955-020-01337-9
  14. Guan WJ, Yuan JJ, Li HM, Huang Y, Chen CL, Gao YH, et al. Health perception and behaviors in adults with bronchiectasis. Respir Care. 2019;64(4):462–72. https://doi.org/10.4187/respcare.06394
  15. Price D, Harrow B, Small M, Pike J, Higgins V. Establishing the relationship of inhaler satisfaction, treatment adherence, and patient outcomes: a prospective, real-world, cross-sectional survey of US adult asthma patients and physicians. World Allergy Organ J. 2015;8(1):26. https://doi.org/10.1186/s40413-015-0075-y
  16. Tong A, Gow K, Wong G, Henning P, Carroll R. Patient perspectives of a young adult renal clinic: a mixed-methods evaluation. Nephrology (Carlton). 2015;20(5):352–9. https://doi.org/10.1111/nep.12396
  17. Al-Saikhan FI. Warfarin therapy adherence and health-related quality of life among patients using warfarin in Saudi Arabia. Niger J Clin Pract. 2020;23(3):398–407. https://doi.org/10.4103/njcp.njcp_608_18
  18. Seston EM, Magola E, Bower P, Chen LC, Jacobs S, Lewis PJ, et al. Supporting patients with long-term conditions in the community: Evaluation of the Greater Manchester Community Pharmacy Care Plan Service. Health Soc Care Community. 2020;28(5):1671–82. https://doi.org/10.1111/hsc.12992
  19. Sacre H, Haddad C, Sakr F, Safwan J, Hajj A, Zeenny RM, et al. Patient-pharmacist relationship dynamics: a mediation analysis of patient characteristics and reported outcomes. J Pharm Policy Pract. 2024;17(1):2371409. https://doi.org/10.1080/20523211.2024.2371409
  20. Leenen LAM, Wijnen BFM, Kessels AGH, Chan H, de Kinderen RJA, Evers SMAA, et al. Effectiveness of a multicomponent self-management intervention for adults with epilepsy (ZMILE study): A randomized controlled trial. Epilepsy Behav. 2018;80:259–65. https://doi.org/10.1016/j.yebeh.2018.01.019.