Challenges and Strategies of Informal Caregivers in Medication Management for Older Adults: A Mixed Method Systematic Review.
Daniela Avgustini, Mayra Veronese, Anna Brugnolli and 2 others
PMID 42434829WHAT IT FOUND
Informal caregivers often took over older adults' medication tasks after decline or acute events.
One study of 100 caregivers found almost 40% reported medication burden; another of 685 found 57% reported mistakes. They used pill boxes, alarms and lists.
Key findings
01Caregiver medication involvement increased when the older adult became more dependent in daily activities, and co-residing caregivers often handled the whole medication process.
02Caregivers reported medication burden and mistakes: almost 40% of 100 caregivers reported medication-related burden, and 57% of 685 reported at least one mistake, including dosage errors (44%), mixing up medications (20%), mishandling medications (31%) and incorrect storage (15%).
03Caregivers used practical strategies such as pill organizers, alarms, handwritten lists and consistent routines.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only English-language studies published from January 2015 to January 2025, so relevant work in other languages or earlier periods may be missing. Most included studies were conducted in high-income countries, so findings may not transfer to settings with different caregiver support and healthcare systems. The five cross-sectional studies had moderate risk of bias, with some outcome measures not clearly valid or reliable and one study not clearly managing confounding. Four qualitative studies did not address researcher reflexivity. Medication errors were reported in only one included study, so error frequency may not represent all caregivers. The review synthesised experiences and self-reported tasks; it did not test whether any strategy or professional support improves adherence or patient outcomes.
Declared interests
No funding or conflicts of interest were reported.
The easy way to misread this
Do not conclude that pill organizers, alarms or professional support improve medication safety. This review reports caregivers' experiences and reported strategies; it did not test an intervention or measure patient outcomes.