Adherencia a la terapia del lenguaje en atención primaria y sus determinantes sociales

Therapeutic adherence in language rehabilitation processes represents a persistent challenge for health systems, particularly in primary care settings and among socially vulnerable populations. This systematic review aimed to identify the barriers and facilitators associated with adherence to language therapy, considering the influence of social determinants of health. A search was conducted in PubMed, Scielo, Lilacs, and Web of Science between 2019 and 2025, following PRISMA 2020 guidelines; twenty-one open-access articles focused on primary care, therapeutic adherence, and social factors were included. The findings indicate that telehealth, community education, and family support are key determinants for maintaining therapeutic continuity, whereas technological, economic, and health literacy limitations constitute the main barriers. It is concluded that strengthening primary care and promoting digital equity are essential strategies to improve adherence and reduce disparities in communicative health.