Perception of Factors Affecting Medication Adherence Among Older Adults: Challenges and Strategies in Primary Health Care in Brazil

The high prevalence of chronic noncommunicable diseases (NCDs) among older adults in Brazil presents substantial challenges to medication adherence—an essential component for ensuring therapeutic effectiveness. Adherence is influenced by a range of factors, including socioeconomic status, cultural beliefs, cognitive decline, and health conditions, all of which demand close attention from professionals in Primary Health Care (PHC). Objective: To analyze the challenges faced by PHC professionals in addressing low medication adherence among older adults with NCDs in a municipality within the Metropolitan Region of Belo Horizonte, Minas Gerais. Methods: This action research was conducted in two stages. The first involved a descriptive phase using an electronic questionnaire distributed to professionals from 38 Basic Health Units (UBS), focusing on their perceptions of medication adherence and their interest in participating in focus groups. The second phase involved conducting two focus group sessions with both care and management professionals. The study adhered to the Standards for Reporting Qualitative Research (SRQR), and the data were analyzed using thematic content analysis, following Bardin’s methodological framework. Results: A total of 131 professionals responded to the questionnaire, the majority being women (87%), aged 40–49 years, with 71.8% affiliated with the Family Health Strategy. Only 15.3% had received specific training in older adult health. Eight professionals participated in the focus group discussions. The primary challenges identified included lack of family support (33.6%), low levels of education (23.7%), complexity of therapeutic regimens (9.9%), limited access to medications (6.9%), and forgetfulness (6.9%). Additional barriers reported were popular beliefs, socioeconomic vulnerability, side effects, self-medication, dementia, and alcohol use. Most professionals attributed non-adherence to a combination of intentional and unintentional causes, such as perceived “cure” due to asymptomatic conditions, cognitive impairment, and shortcomings in comprehensive PHC care. Conclusions: Medication adherence among older adults with NCDs is a multifactorial issue influenced by both social determinants of health and intrinsic aspects of aging. The lack of family support, low education levels, and regimen complexity emerged as central barriers. Strengthening the professional–patient relationship, providing specific training on older adult health, and implementing intersectoral strategies are essential measures to improve clinical outcomes within the scope of Primary Health Care.