Title:
Medication Adherence and Associated Determinants Among Patients in Liquiça Municipality, Timor-Leste: A Correlational Qualitative Study Using the Morisky Medication Adherence Scale (MMAS)

Authors:
Joaquim Gregorio de Carvalho, Joaquim Pinto, Eduardo Crisogono Gaio, Natália Pereira, Eugenia de Carvalho, José Dionisio Ximenes, Eugenia Carvalho de Araújo, Heru Sutopo, Indonesia

Abstract:

Background: Tuberculosis (TB) continues to represent a major global public health concern. In 2023, TB was estimated to have caused approximately 1.25 million deaths worldwide, including around 161,000 deaths among individuals living with HIV. Moreover, drug-resistant TB, particularly multidrug-resistant TB (MDR-TB), remains a persistent public health emergency and poses a substantial threat to global health security. According to the Global TB Report 2023, an estimated 3.8 million people in the WHO South-East Asia Region initiated tuberculosis treatment in 2023. This represents a notable increase compared with 2020, a period during which TB services in the region were substantially disrupted by the COVID-19 pandemic. The Global TB Report further emphasizes that tuberculosis remains a major public health concern in Timor-Leste. Data from the WHO Global TB Report 2024, released on October 29, indicate that Timor-Leste recorded 6,171 newly reported TB cases in 2023, representing a substantial increase compared with previous years.

Objective: To examine medication adherence using the Morisky Medication Adherence Scale (MMAS) in relation to the side effects of Directly Observed Treatment, Short-course (DOTS) in Liquiça Municipality.

Research method: Mehods: This study was conducted in Liquiça Municipality using a quantitative correlational research design. A total of 100 participants were selected through stratified total sampling. Data were collected using structured questionnaires. The relationship between medication adherence and DOTS-related side effects was analyzed using Kendall’s tau-b correlation test. Statistical significance was set at p < 0.05.

Results: The study findings indicated that 32 participants (32%) demonstrated sufficient medication adherence, while 68 participants (68%) exhibited good adherence; none were classified as having low adherence. In terms of DOTS-related side effects, 85 participants (85%) reported minimal side effects, 14 participants (14%) experienced moderate side effects, and 1 participant (1%) reported severe side effects. Bivariate analysis using Kendall’s tau-b revealed a statistically significant relationship between medication adherence and DOTS-related side effects (p = 0.002, < 0.05). The negative correlation coefficient of −0.305 suggested a weak inverse association between the variables.

Conclusion: There is a relationship between patient adherence to medication and the side effects of DOTS.

DOI: http://dx.doi.org/10.51505/ijmshr.2026.10414