Factors Influencing Poor Drug Compliance Among Patients with Diabetes Mellitus: An Experience from Rural Indonesia

Background: Low medication compliance is one of the main challenges in managing Type 2 Diabetes Mellitus (T2DM) in rural areas, increasing the risk of complications. Identifying factors that influence compliance is essential for improving disease management. Methods: This cross-sectional study used data from the 2023 Indonesian Health Survey, including 292 rural T2DM patients who met the inclusion criteria. Variables examined were demographic factors and health-related factors. Odds ratios (OR) were calculated to assess associations with medication compliance. Results: Men and individuals with lower educational levels had a higher likelihood of non-compliance men (OR 1.41; p = 0.302), elementary education or below (OR 1.29; p = 0.618), whereas older age tended to be associated with better compliance (OR 0.98; p = 0.305); however, none of these associations were statistically significant. Unemployed patients had lower odds of non-compliance compared with those who were employed (aOR 0.39; p = 0.002), whereas individuals who only occasionally or never attended follow-up visits had much higher odds of non-compliance than those who did so regularly (p < 0.001 and p < 0.001), and both associations were statistically significant. Medication-related knowledge was significant in the unadjusted model (OR 3.78; p < 0.001), but not after adjustment. Perceived accessibility of health facilities was not significantly associated with non-compliance (p = 0.375). Conclusion: Medication non-compliance among patients with T2DM in rural areas shows an inverse association with being unemployed and older age, and a direct association with lower frequency of follow-up visits, male gender, lower educational level, poorer medication-related knowledge, and perceived poor accessibility of health facilities. Interventions should strengthen rural primary care via flexible service hours, active outreach, and family-involved education, particularly for working-age men. Keywords: diabetes mellitus, poor drug compliance, risk factor, rural areas, Indonesia