POLYPHARMACY AND THERAPEUTIC ADHERENCE IN PRIMARY HEALTH CARE: SCOPING REVIEW

Abstract

Considering the growing prevalence of polypharmacy in Primary Health Care (PHC), particularly among adults with chronic conditions, and its impact on therapeutic adherence, it is essential to understand the factors that interfere with this process. This study aims to map and critically discuss the scientific evidence on polypharmacy-related factors that influence therapeutic adherence and their implications for quality of life among adults receiving care in PHC. To this end, a scoping review was conducted in accordance with the Joanna Briggs Institute recommendations and the PRISMA-ScR checklist, with searches performed in six national and international databases up to June 2025. Studies published in Portuguese, English, or Spanish that addressed polypharmacy in the PHC context were included. The findings indicate that therapeutic adherence is shaped by individual, social, organizational, and therapy-related determinants, particularly regimen complexity, forgetfulness, low social support, failures in patient–provider communication, and structural limitations of health services. Multidisciplinary interventions, pharmacotherapeutic follow-up, and the use of clinical decision support technologies demonstrated potential to improve adherence; however, results were heterogeneous and strongly dependent on the care context. These findings suggest that promoting therapeutic adherence among patients with polypharmacy in PHC requires integrated, continuous, and patient-centered approaches capable of strengthening the rational use of medicines, the safety of care, and quality of life within the Unified Health System.

DOI: https://doi.org/10.56238/sevened2026.009-020