In this study, we aimed to improve the quality of medication support for older patients. We qualitatively examined the factors that form and sustain the state of inconsistency between the prescribed medication and patients’ intentions to take it. The electronic medical record text data of patients hospitalized during the 6-month study period were qualitatively analyzed using Mayring’s qualitative content analysis. Concept saturation was observed in all 30 cases, and 10 categories were generated from 138 text intercepts. Patient-related factors included inability to resolve questions owing to “reticence to others,” “low interest in medication” owing to long-term use, and “adherence to medication” owing to the perception that a prescribed medication is necessary for oneself and fear of physical illness. This may have led to a shift from “understanding and taking” the medication to “taking as prescribed.” Environmental factors included “change in medication,” such as a change in name or addition of a medication owing to a change to a generic or combination drug, and “lack of pharmacist involvement” when there was no change in the regular medication. In conclusion, regardless of changes in their regular prescriptions, it is crucial for pharmacists to ensure that patients fully understand and adhere to their treatment regimens.