Abstract
BACKGROUND: Diabetes mellitus is a chronic disease that requires long-term drug use and medication compliance to achieve optimal disease control. Indonesia's population is predominantly muslim. Fasting during Ramadan presents unique challenges for patients with diabetes mellitus in maintaining medication adherence due to lifestyle changes, such as mealtimes and medication schedules. OBJECTIVE: This study aimed to compare the medication adherence levels among diabetes mellitus patients in Indonesia who fast during the month of Ramadan with those in other regular months. METHODS: A longitudinal study was conducted using a survey of patients with diabetes at the Central Naval Hospital (RSPAL) Dr. Ramelan Surabaya. Data were collected from February to March 2024 using the picture pill count method. Data were analyzed using the chi-square test to determine the differences in medication adherence between the groups recruited during Ramadan and the other months. RESULTS: In both groups, there was a predominance of single-drug and two-drug combination therapies, with metformin being the most widely used drug. The level of adherence to treatment during Ramadan was significantly lower than that during the regular month (p=0.005). In total, 96.5% of patients showed high levels of compliance during the regular month compared to 89% during Ramadan. CONCLUSION: The level of adherence to diabetes treatment among patients with diabetes mellitus during Ramadan was lower than during regular months.