Developing a Medication Self-Management Program to Enhance Medication Adherence Among Older Adults With Multimorbidity Using Intervention Mapping

BACKGROUND AND OBJECTIVES: Suboptimal medication adherence is prevalent in older adults with multimorbidity. However, intervention programs for enhancing adherence in this population are limited. This study describes the development process of a medication self-management program for older adults with multimorbidity. RESEARCH DESIGN AND METHODS: We adopted the first 4 steps of the intervention mapping to develop the program: (1) needs assessment, including a literature review, a systematic review, and a cross-sectional study; (2) development of program outcomes and objectives; (3) selection of theory-based intervention methods and practical applications; and (4) development of the program. RESULTS: We conducted a needs assessment to identify factors affecting medication adherence among older adults with multimorbidity and created a logic model of the adherence problem in Step 1. In Step 2, we developed the specific program outcomes and objectives and then selected adherence information, personal motivation, social motivation, behavioral skills, and treatment experiences as modifiable and important targets that needed to change in this program. In Step 3, we chose several theory-based methods and strategies for practical applications. We finally created a nurse-led medication self-management program in Step 4. Feedback from relevant stakeholders refined the intervention protocol and materials. DISCUSSION AND IMPLICATIONS: The newly developed medication self-management program incorporated theory and evidence from literature and empirical studies with the engagement of multiple stakeholders, making it a contextually and culturally appropriate intervention. This study provides insights into strategies for geriatrics health care professionals to support medication self-management among older adults with multimorbidity.