Determinants of Medication Non-Adherence in 1,750 Indonesian Adults with Chronic Diseases: A Nationwide Cross-Sectional Study

Purpose: Medication adherence is critical for effective chronic disease management, yet non-adherence remains a major challenge. Current evidence on medication adherence in Indonesia is constrained by small sample sizes, narrow geographic scope, and a failure to adequately account for the complex interplay of social, economic, and cultural factors. This study aimed to identify factors associated with medication non-adherence in patients with chronic diseases in Indonesia. Methods: This nationwide cross-sectional study was carried out across 34 provinces in Indonesia during April – November 2024. Participants were patients aged 20– 74 years diagnosed with at least one chronic disease. Medication non-adherence was assessed through an online and offline self-reported survey. Data was analyzed using multivariable logistic regression, with Odds Ratio (OR) and 95% Confidence Interval (CI) reported. Results: Among 1,750 participants, 957 (54.7%) were adherent and 793 (45.3%) were non-adherent. Non-adherence was most prevalent in digestive diseases (371/541; 68.6%) and psychiatric disorders (37/52; 71.2%). In multivariable logistic regression, younger age (20– 30 years: aOR 4.53, 95% CI 2.90– 7.09), residence in Java and Bali (aOR 3.21, 95% CI 1.85– 5.56), lower income ( Conclusion: Medication non-adherence affected nearly half of Indonesian patients with chronic diseases. Strengthening health insurance coverage, addressing financial and geographic disparities, and implementing targeted education strategies, including gender-sensitive approaches that address financial barriers among women and health perception-related factors among men, are essential to improve medication adherence. Keywords: medication, adherence, chronic disease, Indonesia