Medication Adherence and Its Determinants Among Older Adults With Chronic Illnesses in Rural and Urban Gujarat, India: A Community-Based Cross-Sectional Study

Background Medication adherence is essential for effective management of chronic illnesses among older adults. However, non-adherence remains a major challenge in low- and middle-income countries (LMICs), where ageing populations frequently experience multimorbidity and complex treatment regimens. This study assessed the levels of medication adherence and identified factors associated with adherence among geriatric individuals in rural and urban areas of Gujarat, India. Methods A community-based cross-sectional study was conducted from February 2023 to June 2024 among 380 individuals aged ≥60 years receiving long-term medication. Data were collected using a pre-tested questionnaire, and medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations were examined using chi-square tests and multivariable logistic regression. Results Among 380 participants, 194 (51.1%) demonstrated high medication adherence, whereas 156 (41.0%) had low adherence. Medication adherence was significantly associated with gender, place of residence, marital status, occupation, socio-economic status, addiction status, dosing frequency, and routine follow-up behaviour on bivariate analysis. In multivariable logistic regression, higher socio-economic status (aOR = 1.91; 95% CI: 1.16-3.15) and once-daily dosing (aOR = 2.10; 95% CI: 1.19-3.70) were independently associated with better adherence. Forgetfulness was the most commonly reported reason for missed medication doses. Conclusion Medication non-adherence remains common among older adults with chronic illnesses. Higher socio-economic status and simpler dosing regimens were independently associated with better adherence. Interventions promoting regimen simplification and patient support may improve medication adherence in this population.