Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 7, 2026
Date Accepted: Sep 7, 2026
Digital Health Technologies for Medication Adherence in Older Adults With Chronic Diseases: A Scoping Review on Age-Friendly Design and Optimization
ABSTRACT
Background:
Poor medication adherence among older adults remains a persistent challenge, often linked to low self-efficacy and inadequate out-of-hospital support. Although digital health technologies (DHTs) offer promising avenues for remote health management, age-related cognitive and physiological decline, combined with limited digital literacy, exacerbates the digital divide and may impede improvements in health literacy. Thus, there is a dual need: to develop age-friendly DHTs and to adapt corresponding nursing management strategies.
Objective:
This scoping review aimed to identify the evidence on DHT interventions to improve medication adherence in older adults, identifies key effectiveness factors, and proposes age-friendly design and optimization principles to inform better nursing strategies.
Methods:
Following a five-stage scoping review framework and the PRISMA-ScR checklist, a comprehensive search of seven databases was conducted in September 2025. A total of 49 relevant studies were included.
Results:
Guided by the Social Cognitive Theory (SCT), this review synthesized older adults’ experiences with DHTs for medication adherence, identified barriers and facilitators to their use, and derived preliminary design and optimization principles for age-friendly DHTs.
Conclusions:
DHTs open new possibilities for out-of-hospital health management. However, older adults often face a digital divide stemming from cognitive-physiological decline and limited digital literacy, which may in turn hinder the development of their health literacy. Consequently, advancing age-friendly DHTs and adapting nursing strategies have become key priorities in healthcare. Importantly, DHTs do not replace nursing but rather enhance its core purpose. The future relevance of nursing will depend on its ability to bridge technology and humanism to make technology more compassionate and care more evidence-based. This study provides empirical support and strategic insights for this transformation, urging a coordinated response across nursing theory, practice, education, and management. Clinical Trial: doi:10.17605/OSF.IO/ZA6F2
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