Assessing HbA1c and oral antidiabetic drug adherence outcomes in community-based diabetes management at primary care level: An observational study of Indonesian PROLANIS participants

Background/Aim: Poor glycaemic control remains a persistent challenge in patients with type 2 diabetes mellitus (T2DM), particularly within primary healthcare settings in Indonesia. Medication adherence is a key modifiable factor that may influence glycaemic outcomes. This study aimed to evaluate the correlation between glycated haemoglobin (HbA1c) levels and medication adherence among type 2 diabetes mellitus (T2DM) patients participating in the PROLANIS. Methods: This observational study examined the relationship between adherence to oral antidiabetic drugs (OADs) and glycaemic control in patients with T2DM enrolled in the PROLANIS programme at Gending Primary Healthcare Centre, East Java. Fifty adult patients were enrolled in December 2024. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8) and glycaemic control was defined as HbA1c ≤ 7.0 %. Results: High adherence was significantly associated with better glycaemic control (p = 0.011). Patients with high adherence were over six times more likely to improve glycaemic status (OR = 6.69, 95 % CI: 1.32-34.5). ANCOVA revealed that adherence independently predicted change in HbA1c (p < 0.001, η²p = 0.478), while age and baseline HbA1c were non-significant covariates. A strong negative correlation was observed between MMAS-8 scores and HbA1c (r = -0.483, p < 0.001). Conclusion: High OAD adherence was independently associated with improved glycaemic control among T2DM patients in a primary care setting. Interventions targeting medication adherence could enhance the effectiveness of community-based chronic disease management programmes such as PROLANIS.