Abstract
BACKGROUND: Elderly adults suffer from one or more high-cost chronic diseases, consume more medications; therefore, adherence to prescribed treatments is essential to ensure effective management of these conditions. OBJECTIVE: To identify the characteristics that most significantly affect medication adherence among older adults in Colombia. METHODS: This was a quantitative, cross-sectional study with an analytical intent based on all medical records, medication orders, dispensing, and pharmacotherapeutic follow-up of patients over 65 years of age treated by a pharmaceutical manager between 2019 and 2025. Medication adherence was related to certain sociodemographic, clinical, and pharmacological characteristics. The analyses were univariate, bivariate, and multivariate, using an explanatory model to control for potentially confounding variables (with a significance level greater than 5%), crude and adjusted proportion ratios, 95% confidence intervals, and factor analysis using the principal component method. RESULTS: A total of 42,601 records of older adults were evaluated. Medication non-adherence was 5.9%, and pharmacological factors were the most statistically associated, mainly problems of inappropriate use; suffering from various chronic diseases with various pharmacological regimens, coupled with administrative inefficiencies and inappropriate use of medications, are variables that influence non-adherence. CONCLUSION: From a public health perspective, medication adherence in older adults is a determinant of health outcomes and a key factor for the sustainability of health systems. Optimizing adherence requires comprehensive interventions framed within public policies that guarantee continuity of care, timely access to medications, and the strengthening of interdisciplinary teams. Recognizing adherence as a collective, and not just an individual, challenge is essential to reducing preventable complications, lowering hospitalization rates, and improving the quality of life of an increasingly aging population.