The Correlation between Belief and Adherence to Therapeutic Regimens in Pharmaceutical Care for Tuberculosis Patients in Primary Healthcare Centres in Surabaya, Indonesia


  • Abdul Rahem Community Pharmacy Department, Faculty of Pharmacy, Airlangga University Surabaya, Indonesia
  • Yuni Priyandani Community Pharmacy Department, Faculty of Pharmacy, Airlangga University Surabaya, Indonesia
  • Mochamad Djunaedi Community Pharmacy Department, Faculty of Pharmacy, Airlangga University Surabaya, Indonesia


Adherence, Belief, Antituberculosis drugs, Health belief model


Adherence to therapeutic regimens is a health behaviour which can be explained through the concept of the theory of Health Belief Model (HBM) which starts from belief which plays an important role in shaping mindset and patient adherence behaviour. The purpose of this study was to determine the relationship between belief and adherence to the therapeutic regimens in pharmaceutical care models for tuberculosis patients in primary healthcare centres. This research is a quantitative cross sectional analytic study at Perak Timur, Gading, and Manukan Kulon primary healthcare centres in the Surabaya area. Data collection for tuberculosis patients was carried out at the primary healthcare centres for 2 months (from October to November 2017). The independent variable is belief in drug therapy which consists of the sub-variables of perceived threats, perceived benefits, perceived barriers, and perceptions of self-efficacy. The dependent variable was adherence to therapeutic regimens with indicators of the right dosage, right frequency, right interval, right time to take medication, and right duration of therapy. Out of a total of 61 respondents, 32 (52.46%) were found adherent; taking the combination fixed dose antituberculosis drug and 29 (47.54%) patients did not adhere. Analysis of
data with the Spearman Test showed p = 0.004 (p < 0.05) which means there is a correlation between belief and adherence to therapeutic regimens. Our findings showed a significant relationship between belief and adherence to therapeutic regimens in pharmaceutical care for tuberculosis patients attending primary healthcare centres in Surabaya, Indonesia.


World Health Organization, Global tuberculosis report 2019 [online] Available from:,

Accessed August 6, 2020.

East Java Provincial Health Office, 2017, East Java Provincial Health Profile 2016, Surabaya.

Ministry of Health, Republic of Indonesia, Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. National guidelines for controlling tuberculosis. Jakarta. 2014.

Ministry of Health, Republic of Indonesia. Tuberculosis, find and treat until healed. Jakarta: Infodatin Center for Health Data and Information Ministry of Health of the Republic of Indonesia; 2015.

Hussar DA. Patient compliance In: Gennaro AR. (Ed.). Remington, The Science and practice of pharmacy, 21sted; Philadelphia : Lippincott Williams & Wilkins. 2005. 1782-92 p.

Asri SDA. Drug resistant on tuberculosis problem. In: Continuing medical education. Jakarta: Ikatan Dokter Indonesia; 2014. 3 p.

Rovers JP, Currie JD, Hagel HP, McDonough RP, Sobotka JL. A practical guide to pharmaceutical care. The Am Pharm Assoc. 1998. 1-20 p.

Athijah U. Pharmaceutical care model of drug service prescribed and its effect on pharmacist behaviour in the care of pharmacy. Dissertation. Medical Science Study Program, Postgraduate Program, Universitas Airlangga, Surabaya; 2007.

Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice: The patient-centered approach to medication management services. New York: McGraw Hill Education, 2012. 103-138 p.

Paes AH, Bakker A, Soe-Agnie CJ. Measurement of Patient Compliance. Pharm World Sci. 1998; 20:73-77.

Metry JM. Measuring compliance in clinical trials and ambulatory care. In: Metry JM, Meyer UA, editors. Drug regimen compliance, issues in clinical trials and patient management. Chichester: John Wiley & Sons; 1999. 1-21 p.

Glanz K, Rimer BK, Viswanath K. Health behaviour and health education: theory, research, and practice. 4th ed. San Francisco, Jossey-Bass: Wiley Imprint; 2008.

Lemeshow S, Hosmer DW, Klar J, Lwanga SK. Adequacy of sample size in health studies. World Health Organization; 1990. 41-47 p.

Djunaedi M, Athiyah U, Priyandani Y, Sulaiman SAS. A case of ethambutol-induced optic neuropathy in diabetic patient with co-existing pulmonary tuberculosis. 17th ACCPProceeding, Taylor and Francis; 2017.

Priyandani Y, Setiawan CD, Yuda A, Nita Y, Athiyah U, Qomaruddin MB, Kuntoro. The influence of adverse reactions of antituberculosis drugs to non-adherence in drug use. 17th ACCP Proceeding, Taylor and Francis; 2017.

Janz NK and Becker MH. The health belief model: a decade later. Health Educ Q; 1984; 11(1):1e47.

Chang LC, Hung LL, Chou YW, Ling LM. Applying the health belief model to analyze intention to participate in preventive pulmonary tuberculosis chest X-ray examinations among indigenous nursing students. J Nurs Res. 2007; 15(1):78e87.

Li X, Jiang S, Li X, Mei J, Zhong Q, Xu W, Li J, Li W, Liu X, Zhang H, Wang L. Predictors on delay of initial healthseeking in new pulmonary tuberculosis cases among migrants population in East China. PLoS One 2012; 7(2):e31995.

Rodriguez-Reimann DI. Acculturation and health beliefs of Mexican Americans regarding tuberculosis prevention. J Immigr Health 2004; 6(2):51e62.

Yang WT, Gounder CR, Akande T, De Neve JW, Mclntire KN, Chandrasekhar A, Pereira PL, Gummadi N, Samanta S, Gupta A. Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter? Tuberc Res Treat. 2014; Article ID 461935, 15 pages.

Li ZT, Yang SS, Zhang XX, Fisher EB, Tian BC, Sun XY. Complex relation among Health Belief Model components in TB prevention and care. Pub Health 2015; 129(7):907- 915.

Poss JE. Factors associated with participation by Mexican migrant farmworkers in a tuberculosis screening program. Nurs Res 2000; 49(1):20e8.




How to Cite

Rahem, A., Priyandani, Y., & Djunaedi, M. (2020). The Correlation between Belief and Adherence to Therapeutic Regimens in Pharmaceutical Care for Tuberculosis Patients in Primary Healthcare Centres in Surabaya, Indonesia: Tropical Journal of Natural Product Research (TJNPR), 4(8), 355–359. Retrieved from