Patient Engagement Interventions to Improve Medication Management of Older Patients Across Transitions of Care: A Mixed Methods Systematic Review

AIMS: Identify and describe patient engagement interventions used to improve medication management in older adults during transitions of care. DESIGN: A mixed-methods systematic review. METHODS: A comprehensive search of all study designs was conducted. Studies were categorised using the ladder of patient and family engagement, a framework that positions engagement from low (passive) to high (active partnership) patient engagement. DATA SOURCES: Six databases were searched from inception to April 2024. RESULTS: The search yielded 29 reports, with 25 classified as studies. Most interventions (n = 19, 76%) were low-level interventions that comprised informing patients in a passive manner. Interventions that facilitated high-level engagement (n = 6, 24%) where patients were integrated in the decision-making process were associated with consistently improved patient and healthcare long-term outcomes. CONCLUSIONS: While low and high-level engagement interventions were associated with significantly decreased hospital readmission rates, high-level interventions consistently demonstrated positive patient outcomes. Interventions supporting older adults beyond discharge achieved meaningful and lasting patient and healthcare outcomes for older adults. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Findings provide clinical reference for designing engagement interventions, highlighting long-term benefits of partnership-based approaches and continuity beyond discharge. IMPACT: Engagement in medication management during transitions of care varied significantly. High-level engagement was consistently linked to improved patient and healthcare outcomes but was often resource intensive. This review identifies the need to design balanced interventions that align with the preferences of older adults and real-world contextual healthcare settings. REPORTING METHOD: PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. PROTOCOL REGISTRATION: PROSPERO (registration number CRD42024557385).