OBJECTIVES

: Compared with men, women generally live longer, and tend to have more diagnosed chronic conditions, which often requires lifelong, complex medication regimen. Numerous publications have exposed that medication non-adherence is a significant problem in elderly female patients, furthermore diseases that they face, differs from elderly male’s. The aim was to provide an overview on empirical evidence of adherence to polypharmacotherapy in multimorbid elderly women.

METHODS

: A systematic literature review following the PRISMA guideline principles was conducted using Pubmed, Embase, Academic Search Complete and EBSCO CINAHL databases, limited to English language publications from the last ten years. Search strategy (finalized in January 2021) was built up as a combination of search strings applying synonyms of adherence, medication, polypharmacy, multimorbidity, elderly women and postmenopause. Data on medication adherence both as explanatory and/or outcome variables were extracted by two researchers independently.

RESULTS

: Of the 1607 records screened, 43 were eligible for full-text review. Majority of the studies were excluded due to lack of subgroup analysis specific to women. From the included 24 studies, 13 used adherence as an outcome variable, one as explanatory variable and two for both. Eight studies reported descriptive statistics on elderly women’s medication adherence. All but one of the studies evaluating adherence as an outcome variable suggested that women tend to be more adherent than men. Additionally, age and having more comorbidities decreased women’s adherence. As explanatory variable, medication adherence was assessed in patients with hip fracture, depression and in a mixed-disease population study. Adherence measurement methodologies differed across the included studies.

CONCLUSIONS

: Our study identified limited quantitative evidence for adherence to polypharmacotherapy in the subgroup of multimorbid elderly women. A better understanding and further empirical studies are needed on the influencing factors and consequences of medication non-adherence to develop effective adherence interventions for this vulnerable patient population.