Predictors of Medication Adherence among Multidrug-resistant Tuberculosis Patients in West Kalimantan: A Cross-sectional Study

Abstract

Multidrug-resistant tuberculosis (MDR-TB) poses major treatment challenges in Indonesia, where adherence is crucial for therapeutic success. This cross-sectional study identified predictors of medication adherence among 30 MDR-TB patients at Dr. Soedarso Hospital, Pontianak, West Kalimantan, in 2023. Adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8), and sociodemographic, clinical, and psychological data were analyzed through logistic regression. Most patients (73.3%) demonstrated high adherence. Self-efficacy was the strongest independent predictor (AOR = 7.88; 95% CI: 2.01–29.51; p = 0.002). Other positive factors included higher education (AOR = 4.62), employment (AOR = 3.21), older age (AOR = 1.08), higher body mass index (AOR = 1.33), and longer treatment duration (AOR = 1.27). Distance to hospital negatively affected adherence (AOR = 0.85). These results indicate that MDR-TB adherence is shaped by psychological resilience, socioeconomic stability, and clinical condition, while geographical barriers persist. Integrated interventions that combine counselling, education, nutritional and financial support, and decentralized care are essential to improve adherence and treatment outcomes in high-burden regions such as West Kalimantan.