Medication adherence refers to the extent to which a person correctly follows the instructions for taking their prescribed medications. This includes taking the right dose at the right time, following any specific instructions for food or activity, and continuing the medication for the prescribed length of time. Adherence is crucial for managing chronic conditions, as failing to follow medication instructions can lead to worsened health, complications, and hospitalisations. Achieving good adherence can help improve overall health outcomes, reduce the risk of complications, and ensure the effectiveness of treatments.

The ADHERE trial, which stands for Assessing the Impact of Automated Devices for Enhancing Health and Reducing Medication Errors in Older Adults with Long-Term Health Conditions, is a randomised controlled trial designed to evaluate the effectiveness of Automatic Medication Dispensers (AMDs) in improving medication adherence among older adults. The trial aims to determine whether these devices can help reduce medication errors, ensure medications are taken as prescribed, and ultimately improve health outcomes for people managing chronic conditions. Participants will be randomly assigned to either use an AMD for six months or continue with their usual medication routine. The trial will measure the impact of the device on medication adherence, health improvements, and any potential reduction in health complications. By gathering data on these factors, the trial hopes to provide valuable insights into how AMDs can support older adults in managing their health more effectively.

The ADHERE trial will involve 144 participants, with 72 randomly assigned to use an Automatic Medication Dispenser (AMD) for six months, and 72 continuing with their usual care. The study will be conducted across eight pharmacies in Bedford, Luton, and Milton Keynes, allowing a broad range of participants from these areas to take part. Data will be collected at three key points: baseline, three months, and six months. This will help assess the impact of the AMD on medication adherence, health outcomes, and any changes in the management of long-term health conditions over the course of the trial. The aim is to provide valuable insights into the effectiveness of AMDs in improving the health and wellbeing of older adults with chronic conditions.

The target population for this study consists of adults aged 65 years and older who have been diagnosed with at least one long-term health condition. Participants must be prescribed a stable daily medication regimen, with no more than four doses per day. Eligible individuals may experience physical and/or memory-related difficulties in taking their medication and/or have self-reported low medication adherence, assessed using the Morisky Medication Adherence Scale (MMAS-8). Those with an adherence score of less than 8 will be included, as this score has been previously identified as a reliable indicator of non-adherence in older adults. Additionally, participants may have previously tried and found other compliance aids, such as dosette boxes, calendar clocks, blister packs, or talking labels, to be unsuccessful. All participants must have sufficient English language skills and provide written informed consent to take part in the study.

Principal Investigator: Dr Erica Cook

Research Fellow: Dr Jodi Emma Wainwright

Trial Sponsor: Professor Gurch Randhawa

Statistician: Dr Ashley Bennett