(292) Knowledge and Barriers in Medication Adherence and Prescription Appropriateness Tools: A Cross-Sectional Study in Clinical Practice

Background: Poor medication adherence is a global health issue. Polypharmacy and potentially inappropriate medications are associated with adverse events and interactions, especially in older people. While tools to enhance medication adherence and ensure appropriate prescriptions exist, their translation into clinical practice remains unclear. Barriers limiting their use among healthcare professionals are also poorly documented.

Objectives: This study aims to assess healthcare professionals’ knowledge of the tools currently used in clinical practice to enhance patient medication adherence and support prescription appropriateness. Additionally, it aims to gather insights into these tools and to identify barriers hindering their adoption.

Methods: Between October and December 2023, Italian physicians, pharmacists, and nurses from public hospitals and outpatient clinics participated in an anonymous online survey. The survey, comprising both closed and open-ended questions, aimed to assess adoption, perceived utility, barriers and willingness to recommend tools for medication adherence in the future (such as pillboxes, reminders, and mobile applications), as well as the utilization of appropriate prescribing practices (e.g., Beers and START/STOPP criteria, UptoDate, and relevant software). Data were analyzed using descriptive statistics and differences were assessed with Chi-square or Fisher’s exact tests. Qualitative content analysis was independently performed by two researchers and used to interpret and categorize open-ended responses.

Results: Out of 660 respondents, 67% were women, and 54% were aged 40-60. The survey participants were primarily pharmacists (35%), nurses (26%), and general practitioners (22%). The traditional pillbox was the most recommended adherence tool, particularly favored by general practitioners and pharmacists (66-67%) and deemed the most useful, with 70% of healthcare professionals expressing willingness to use it in the future. Barriers to pillbox use included the need for caregiver support and careful box filling. Mobile apps were identified as promising (40% of responders would suggest them in the future) but underused in clinical practice due to older patients’ poor digital literacy. The most used tool to evaluate prescription appropriateness were Beers Criteria (34%) and prescription software (23%).

Conclusions: Traditional pillboxes were the most used strategy to promote medication adherence in clinical practice. Digital adherence tools offer promising future perspectives for enhancing patients’ medication adherence. However, educational interventions are necessary to improve the digital literacy of patients and caregivers, and to foster innovative strategies aimed at overcoming barriers.