Association Between Medication Adherence and Tuberculosis Therapy Success: A Cross-Sectional Study at Community Health Centers in Kediri City, Indonesia

Background: Tuberculosis (TB) remains a critical global public health burden. Indonesia ranks second worldwide in TB incidence, and treatment success rates at primary care level remain below national targets. Medication non-adherence is a leading driver of therapy failure and drug resistance. Objective: This study aimed to determine the association between medication adherence and therapy success in TB patients at community health centers (Puskesmas) in Kediri City, to estimate the strength of this association using binary logistic regression, and to describe adherence across demographic subgroups. Methods: An analytic observational study with a cross-sectional design was conducted from December 2025 to January 2026 at Kediri City Puskesmas. All 75 eligible patients were included using total sampling. Adherence was measured using the Medication Adherence Report Scale-5 (MARS-5; total score 5–25; 25 = high adherence, < 25 = low adherence). Therapy outcomes (success or failure) were retrieved from the national TB Information System (SITB). Data were analyzed using the chi-square test and binary logistic regression. Results: High adherence was observed in 62.7% of patients (n = 47), and therapy success was achieved in 66.7% (n = 50). Therapy success was 78.7% among patients with high adherence and 46.4% among those with low adherence (p = 0.004). In binary logistic regression, low adherence was associated with lower odds of therapy success (OR = 0.234; 95% CI: 0.084–0.649; p = 0.005), equivalent to 4.27 times greater odds of treatment failure (95% CI: 1.54–11.90). High adherence was less frequent among men (44.4%) than women (90.0%; p < 0.001) and among senior-high-school graduates (32.4%; education overall p < 0.001). Conclusion: Medication adherence was significantly associated with therapy success in TB patients at Kediri City Puskesmas, and low adherence was associated with higher odds of treatment failure. Pharmacist-led and PMO-coordinated adherence interventions should be prioritized, particularly for male patients.