Introduction Diabetes and hypertension are prevalent non-communicable diseases in India, with poor medication adherence contributing to complications, hospitalizations, and increased healthcare burden. This research was done to assess the adherence to medication and factors associated with it among patients with diabetes and hypertension in rural Tamil Nadu. Materials and methods A hospital-based analytical cross-sectional study was conducted over three months (April-June 2025) among diabetic and hypertensive patients attending the outpatient department of a Rural Health Centre in Tiruvallur, Tamil Nadu. Adults diagnosed with diabetes mellitus and/or hypertension for at least one year and who consented to the study were included. The required sample size was 174, based on a prevalence of 67.1% medication adherence, and 195 participants were ultimately enrolled. Data were collected using a pretested questionnaire covering sociodemographic details, disease status, and the Simplified Medication Adherence Questionnaire. Ethical clearance was obtained from the Institutional Ethics Committee of Sri Ramachandra Institute of Higher Education and Research (approval number: CSP-MED/25/FEB/113/30). Statistical analysis was done using SPSS Statistics (IBM Corp., IBM SPSS Statistics for Windows. Armonk, NY: IBM Corp.). Results The age of study participants ranged from 35 to 85 years, and the average age was 57.05 years. Most of the participants were females (53.3%, n=104); 36.9% (n=72) of the participants had only diabetes, 24.6% (n=48) had only hypertension, and 38.5% (n=75) had both conditions. The prevalence of medication adherence was 58.5% (n=114, 95% CI: 51.4-65.2). Patients aged ≤50 years (OR: 2.19, p=0.020) and those on monotherapy (OR: 2.03, p=0.033) were significantly more adherent. Other variables such as sex, marital status, socioeconomic status, and comorbidities were not significantly associated with adherence. Conclusions Nearly half the patients were non-adherent, posing a public health concern. Age and complexity of drug regimen were significant predictors of adherence. Interventions such as patient education, fixed-dose combinations, and digital reminders should be prioritized to improve adherence and reduce complications.
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