The Role of Medication Organizers and Supportive Interventions in Improving Adherence Among Patients with Chronic Diseases: A Review of the Current State of Knowledge
DOI:
https://doi.org/10.12775/QS.2026.76.76139Keywords
adherence, medication organizers, chronic diseases, telemedicine, pharmacotherapy, therapeutic adherenceAbstract
Introduction and objective:
Non-adherence to therapeutic recommendations constitutes a significant challenge in the management of chronic diseases and is associated with poorer disease control, increased risk of hospitalization, and higher healthcare costs. It particularly affects older adults, patients with multimorbidity, and those receiving polypharmacy. The aim of this study is to present the current state of knowledge regarding the role of medication organizers and supportive interventions in improving adherence.
Review methods: A narrative review was conducted based mainly on PubMed-indexed publications and references cited in selected studies concerning adherence-supporting interventions in adults with chronic diseases.
Brief description of the current state of knowledge: Available evidence suggests that medication organizers, blister packaging, electronic dispensers, mobile applications, text message reminders, and remote monitoring systems may support regular medication intake. The greatest benefits are observed when non-adherence results from forgetfulness, organizational difficulties, or complex treatment regimens. Their effectiveness depends on the type of intervention, patient characteristics, follow-up duration, and additional educational or behavioral support.
Summary: Medication organizers and supportive interventions may improve adherence among patients with chronic diseases, particularly in high-risk groups. However, they should not be considered a standalone solution, but rather a component of comprehensive care. Further studies are needed to assess the durability of effects and the optimal selection of interventions.
References
1. Cross AJ, Elliott RA, Petrie K, Kuruvilla L, George J. Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications. Cochrane Database Syst Rev. 2020; 5(5): CD012419. https://doi.org/10.1002/14651858.CD012419.pub2
2. Svarstad BL, Brown RL, Shireman TI. A successful intervention to improve medication adherence in Black patients with hypertension: Mediation analysis of 28-site TEAM trial. J Am Pharm Assoc (2003). 2022; 62(3): 800-808.e3. https://doi.org/10.1016/j.japh.2022.01.002
3. Xu W, Lin X, Lai H, Ren Y, Peng S, Lin T. Development and evaluation of a comprehensive Patient for Medication Safety (PFMS) intervention programme to improve participation in medication safety behaviours among older adults with chronic disease during hospital-to-home transition: a pilot randomized controlled trial. BMC Geriatr. 2025; 25(1): 861. https://doi.org/10.1186/s12877-025-06563-8
4. Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications. Cochrane Database Syst Rev. 2011; 2011(9): CD005025. https://doi.org/10.1002/14651858.CD005025.pub3
5. Shah G, Erickson JL, Luxenburg J, Hu B, Reali-Sorrell M, Lovelace R, Pfoh E, Kobaivanova N, Brateanu A. Impact on patients' compliance with medication using prepacked blisters for multidrug medical therapy: I-COMPLY Study. Am J Health Syst Pharm. 2021; 78(18): 1713-1719. https://doi.org/10.1093/ajhp/zxab193
6. Palmer MJ, Machiyama K, Woodd S, Gubijev A, Barnard S, Russell S, Perel P, Free C. Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults. Cochrane Database Syst Rev. 2018; 6(6): CD012675. https://doi.org/10.1002/14651858.CD012675.pub2
7. Kurup R, Martínez JPD, Doucet M, Tyrrell PN. Effectiveness of Electronic Medication Packaging Devices on Medication Adherence: A Scoping Review. J Gerontol Nurs. 2020; 46(3): 27-36. https://doi.org/10.3928/00989134-20200129-01
8. Graetz I, Hu X, Kocak M, Krukowski RA, Anderson JN, Waters TM, Curry AN, Robles A, Paladino A, Stepanski E, Vidal GA, Schwartzberg LS. Remote Monitoring App for Endocrine Therapy Adherence Among Patients With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2024; 7(6): e2417873. https://doi.org/10.1001/jamanetworkopen.2024.17873
9. Miguel-Cruz A, Bohórquez AF, Parra PAA. What does the literature say about using electronic pillboxes for older adults? A systematic literature review. Disabil Rehabil Assist Technol. 2019; 14(8): 776-787. https://doi.org/10.1080/17483107.2018.1508514
10. Huang HY, Maguire MG, Miller ER III, Appel LJ. Impact of pill organizers and blister packs on adherence to pill taking in two vitamin supplementation trials. Am J Epidemiol. 2000; 152(8): 780-787. https://doi.org/10.1093/aje/152.8.780
11. Zedler BK, Kakad P, Colilla S, Murrelle L, Shah NR. Does packaging with a calendar feature improve adherence to self-administered medication for long-term use? A systematic review. Clin Ther. 2011; 33(1): 62-73. https://doi.org/10.1016/j.clinthera.2011.02.003
12. Kalichman SC, Cain D, Cherry C, Kalichman M, Pope H. Pillboxes and antiretroviral adherence: prevalence of use, perceived benefits, and implications for electronic medication monitoring devices. AIDS Patient Care STDS. 2005; 19(12): 833-839. https://doi.org/10.1089/apc.2005.19.833
13. Petersen ML, Wang Y, van der Laan MJ, Guzman D, Riley E, Bangsberg DR. Pillbox organizers are associated with improved adherence to HIV antiretroviral therapy and viral suppression: a marginal structural model analysis. Clin Infect Dis. 2007; 45(7): 908-915. https://doi.org/10.1086/521250
14. Stip E, Vincent PD, Sablier J, Guevremont C, Zhornitsky S, Tranulis C. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia. Front Pharmacol. 2013; 4: 100. https://doi.org/10.3389/fphar.2013.00100
15. Choi EPH. A Pilot Study to Evaluate the Acceptability of Using a Smart Pillbox to Enhance Medication Adherence Among Primary Care Patients. Int J Environ Res Public Health. 2019; 16(20): 3964. https://doi.org/10.3390/ijerph16203964
16. Redfern J, Tu Q, Hyun K, Hollings MA, Hafiz N, Zwack C, Free C, Perel P, Chow CK. Mobile phone text messaging for medication adherence in secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2024; 3(3): CD011851. https://doi.org/10.1002/14651858.CD011851.pub3
17. Hartch CE, Dietrich MS, Lancaster BJ, Stolldorf DP, Mulvaney SA. Effects of a medication adherence app among medically underserved adults with chronic illness: a randomized controlled trial. J Behav Med. 2024; 47(3): 389-404. https://doi.org/10.1007/s10865-023-00446-2
18. Jerene D, van Kalmthout K, Levy J, Alacapa J, Deyanova N, Dube T, Mganga A, Tasca B, Bogdanov A, Efo E, Gamazina K, Garfin AMC, Kochanov V, Leung A, Madden N, Maraba N, McQuaid CF, Mleoh L, Onjare B, Powers R, Terleiva Y, van Rest J, Gebhard A, Fielding K, Charalambous S. Effect of digital adherence technologies on treatment outcomes in people with drug-susceptible tuberculosis: four pragmatic, cluster-randomised trials. Lancet. 2025; 405(10485): 1155-1166. https://doi.org/10.1016/S0140-6736(24)02847-2
19. Krukowski RA, Hu X, Arshad S, Anderson JN, Stepanski E, Vidal GA, Schwartzberg LS, Graetz I. Symptom Monitoring App Use Associated With Medication Adherence Among Women Survivors of Breast Cancer on Adjuvant Endocrine Therapy. JCO Clin Cancer Inform. 2024; 8: e2400179. https://doi.org/10.1200/CCI-24-00179
20. Msosa TC, Phuka F, Sumari-de Boer M, Mhango O, Twabi HH, Mukoka M, Swai I, Aarnoutse R, Rinke de Wit TF, Ngowi K, Lunda E, Mphande W, Msefula C, Nliwasa M. The Acceptability of a Real-Time Medication Monitoring-Based Digital Adherence Tool Among Young People Living with HIV in Malawi. AIDS Behav. 2026; 30(2): 379-391. https://doi.org/10.1007/s10461-025-04885-7
21. Spieker AJ, Nelson LA, Rothman RL, Roumie CL, Kripalani S, Coco J, Fabbri D, Levy P, Collins SP, Wang T, Liu D, McNaughton CD. Feasibility and Short-Term Effects of a Multi-Component Emergency Department Blood Pressure Intervention: A Pilot Randomized Trial. J Am Heart Assoc. 2022; 11(5): e024339. https://doi.org/10.1161/JAHA.121.024339
22. Nimkar RK, Balkhande RW, Patil RS, Agarwal DM, Apte AA. Evaluation of acceptability and feasibility of using manual pill organizers and pill reminder apps for improving medication adherence among elderly population from rural Maharashtra. Indian J Pharmacol. 2025; 57(3): 150-158. https://doi.org/10.4103/ijp.ijp_960_24
23. Bartlett Ellis RJ, Knisely MR, Boyer K, Pike C. Pillbox intervention fidelity in medication adherence research: A systematic review. Nurs Outlook. 2017; 65(4): 464-476. https://doi.org/10.1016/j.outlook.2016.12.011
24. Levin JB, DelBello M, Modi AC, Briggs F, Forthun LF, McVoy M, Yala J, Cooley R, Black J, Conroy C, Sajatovic M. A 6-month, prospective, randomized controlled trial of customized adherence enhancement versus a bipolar-specific educational control in poorly adherent adolescents and young adults living with bipolar disorder. Bipolar Disord. 2024; 26(7): 696-707. https://doi.org/10.1111/bdi.13489
25. Josendal AV, Bergmo TS. Medication Self-Management for Home Care Users Receiving Multidose Drug Dispensing: Qualitative Interview Study. JMIR Aging. 2024; 7: e57651. https://doi.org/10.2196/57651
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Wiktoria Magdalena Kostuch, Julianna Rozalia Chyl, Łukasz Kowalewski , Amir Naziri, Maria Aleksandra Styczyńska , Agata Zimon, Martyna Zielnik , Jan Wojciech Kozera
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 7
Number of citations: 0
