Reasons for medication non-adherence among diabetes mellitus patients in Kelantan: A cross-sectional study

Objectives The main objective of this study was to investigate self-reported reasons for medication non-adherence among type 2 diabetes mellitus (T2DM) patients in Kelantan. Methods A cross-sectional study was conducted among a representative sample of the Kelantanese population of T2DM patients who refilled their medications at government health clinics between April 15th and May 31st, 2025 ( n = 458). Medication adherence was measured using the Simplified Medication Adherence Scale (SMAQ). Reasons for medication non-adherence were obtained via a structured interview. Associations between baseline characteristics and low adherence were estimated using the chi-squared test. Results The survey response rate was 83.2% (472/566). Three percent (14/472) of respondents were excluded from the analysis due to missing data. The top five reasons for non-adherence were ‘I forgot' 92.3% (385/417), ‘I was late for/missed the medication refill appointment at the pharmacy counter' 31.2% (130/417), ‘Nobody reminds me to take the medications' 24.7% (103/417), ‘There are too many medications to take' 22.1% (92/417) and ‘I feel healthy' 21.6% (90/417). The prevalence of low adherence was 18.8% (86/417). Distance from home to clinic >5 km ( p = 0.045) and the need for assistance in medication taking ( p = 0.035) were significantly associated with low adherence. Conclusions Our study identified several key reasons for medication non-adherence among patients with T2DM in Kelantan, including forgetfulness, missed refill appointments, lack of reminders, polypharmacy, and the perception of being healthy. Distance to the clinic and reliance on others for medication administration were significantly associated with low adherence. These findings highlight the need for patient-centred interventions that address both behavioural and structural barriers to adherence.