Prosiding Seminar Kesehatan Masyarakat [Proceeding of Public Health Seminar]

Medication Adherence and Therapeutic Success in Type 2 Diabetes Mellitus: A Narrative Review

Annisa Juliarsih, Sudirman Sudirman, Ahmad Yani — Fri, 31 Jul 2026 00:00:00 +0000

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring long-term pharmacological treatment and sustained self-management. Medication adherence is a critical determinant of glycemic control and therapeutic outcomes; however, suboptimal adherence remains a persistent challenge in outpatient diabetes care.. Method: This narrative review synthesized open-access evidence published predominantly between 2021 and 2026. Literature was identified through PubMed/MEDLINE, ScienceDirect, SpringerLink, Wiley Online Library, DOAJ, and Google Scholar, supplemented by reports from the World Health Organization, International Diabetes Federation, Indonesian Ministry of Health, and BPJS Kesehatan. The synthesis focused on evidence regarding medication adherence among outpatients with T2DM, determinants of non-adherence, and its implications for HbA1c, glycemic control, quality of life, and therapeutic outcomes. Results: The reviewed evidence indicates that adherence to antidiabetic medications remains suboptimal and is generally associated with poorer glycemic control. Non-adherence is influenced by multidimensional factors, including inadequate knowledge, medication beliefs, low self-efficacy, depressive symptoms, regimen complexity, polypharmacy, adverse effects, comorbidities, treatment costs, limited family support, medication accessibility, and healthcare-provider communication. Patient-centered interventions, particularly pharmacist-led counseling, regimen simplification, family engagement, and structured chronic disease management, demonstrate potential to improve adherence and clinical outcomes. Conclusion: Medication adherence should be routinely assessed as an integral component of T2DM management before treatment intensification. Multilevel, patient-centered, and health-system-supported interventions are required to address modifiable barriers and improve adherence, glycemic control, quality of life, and therapeutic outcomes

Life-Course and Multisectoral Determinants of Childhood Stunting in Low- and Middle-Income Settings

Muhammad Muhibbi — Fri, 31 Jul 2026 00:00:00 +0000

Background: Childhood stunting remains a major public health and human development challenge in low- and middle
income countries, including Indonesia. Stunting reflects cumulative growth impairment resulting from interconnected
nutritional, biological, maternal, environmental, socioeconomic, and health-system conditions. This review aimed to
synthesize recent evidence on the determinants of childhood stunting and identify implications for integrated prevention
across the life course. Method: A narrative review was conducted using literature published primarily between 2021 and
2026 from PubMed/MEDLINE, Embase, Scopus, Web of Science Core Collection, ProQuest Dissertations and Theses, and
PubMed Central, complemented by reports from WHO, UNICEF, the World Bank, and the Indonesian Ministry of Health.
The review was informed by PRISMA 2020 principles and employed thematic synthesis using life-course and
socioecological perspectives. Results: Evidence indicates that stunting results from interacting determinants rather than a
single causal pathway. Important factors included low birth weight, prematurity, inadequate maternal nutrition and antenatal
care, suboptimal breastfeeding and complementary feeding, recurrent infections, household food insecurity, poverty, low
maternal education, inadequate water, sanitation and hygiene, and limited access to preventive health services. Stunting
was also associated with wasting, underweight, impaired cognitive development, reduced school readiness, and adverse
long-term human capital outcomes. Conclusion: Stunting prevention requires integrated and multisectoral interventions
beginning before conception and extending through the first 1,000 days and early childhood. Priorities include maternal
and child nutrition, optimal infant feeding, WASH, infection prevention, growth monitoring, food security, social
protection, and responsive caregiving to reduce health inequities and improve child growth and development.