Abstract
Background
Medication adherence is critical for effective management of chronic diseases among older adults. While non-adherence is common in India, limited qualitative research has explored how older adults, pharmacists, and physicians perceive the behavioral, communication-related, and contextual factors influencing long-term medicine use.Objectives
To explore medication adherence among older adults with chronic illness by examining the perspectives of patients, pharmacists, and physicians on behavioral, communication-related, and contextual factors influencing long-term medicine use.Methods
This qualitative study was conducted as part of a larger community-based mixed-methods study in urban and rural areas of western India. In-depth interviews were conducted with 40 participants, including 20 older adults (≥60 years), 13 pharmacists, and 7 physicians. Participants were selected purposively. Interviews were audio-recorded, transcribed verbatim, translated where necessary, and analyzed using Braun and Clarke's inductive thematic analysis. Triangulation across participant groups enhanced the credibility of the findings.Results
Six interconnected themes emerged, highlighting how medication adherence is shaped by symptom-based understanding of illness, daily routines, family support, communication experiences, healthcare interactions, and structural constraints. Absence of symptoms was frequently interpreted as disease control, contributing to both intentional and unintentional non-adherence. Trust in healthcare providers, clear explanations, and pharmacist-led counseling facilitated adherence, whereas communication gaps, financial burden, and polypharmacy acted as barriers. Participants described using practical self-management strategies, including medication routines, reminder systems, and family support, to sustain long-term medicine use.Conclusion
Medication adherence among older adults is influenced by interconnected behavioral, social, communicative, and structural factors. Strengthening patient education, counseling, and provider-patient communication, while addressing financial and treatment-related barriers, may improve long-term adherence. Multidisciplinary, patient-centered approaches are needed to support chronic disease management in aging populations.