The study is very useful in that it adds to current understanding of the reasons for poor rates of medication adherence in older adults. However, we have to note that even in this setting, in which medications are free and medical care is accessible and of excellent quality, medication adherence was poor. The study supports the view that a multilayered intervention can improve medication adherence and underscores the value of pharmacists as key providers of patient counseling in correcting poor patient adherence. The interventions also are potentially generalizable. Despite some cost considerations, medication blister packs can be made for individual patients, and pharmacists are available, skilled, and interested in providing specific counseling about drugs.

It’s been clear for some time that the complex, labor-intensive interventions can be helpful in improving compliance. FAME appears to be another example of this principle. Moreover, there are special conditions (eg, no cost meds, Hawthorne Effect) in play.

That “multi-layered” (AKA “shotgun”) approaches are successful in improving compliance does not confirm the current treatment adherence concepts but only demonstrates that if everything possible is done for certain groups of patients, some of them will take higher proportions of their prescribed meds.