Medical Sains : Jurnal Ilmiah Kefarmasian https://ojs.ummada.ac.id/index.php/iojs <pre id="tw-target-text" class="tw-data-text tw-text-large tw-ta" dir="ltr" data-placeholder="Translation"><strong>Medical Sains : Jurnal Ilmiah Kefarmasian</strong> published four times a year by<br />Universitas Muhammadiyah Ahmad Dahlan Cirebon <strong>(UMMADA)</strong>.<br />Contains writings taken from the results of research and analysis in the field of Pharmacy.<br />This journal is a means for publishing research results related to the field of<br />Pharmaceutical Sciences. Published four times a year, namely January-March,<br />April-June, July-September, and October-December</pre> Universitas Muhammadiyah Ahmad Dahlan Cirebon en-US Medical Sains : Jurnal Ilmiah Kefarmasian 2541-2027 ANTIOXIDANT ACTIVITY OF TEGINING GANANG (Senna hirsuta L) LEAF EXTRACT USING DPPH METHOD https://ojs.ummada.ac.id/index.php/iojs/article/view/1724 <p>Tegining ganang (<em>Senna hirsuta</em> L) is a commodity plants on Lombok Island and is traditionally used to treat minor wounds, severe wounds, and skin infections. This study aimed to evaluate the antibacterial and antioxidant activities of ethanol, ethyl acetate, and n-hexane extracts of Tegining ganang leaves against <em>Staphylococcus aureus</em> and <em>Escherichia coli</em> using the DPPH method. The results showed that the ethyl acetate extract exhibited the highest antibacterial activity. <em>Escherichia coli</em> with an inhibition zone of 8.16 mm. For <em>Staphylococcus aureus</em>, the inhibition zone was 1.16 mm. However, all three extracts demonstrated weak antifungal activity. Phytochemical screening revealed the presence of alkaloids and flavonoids in all the extracts. Additionally, the ethanol and ethyl acetate extracts contained phenolic compounds and tannins, which were absent in the n-hexane extract. In the antioxidant activity assay, the 96% ethanol extract demonstrated excellent antioxidant activity with average absorbance values of 0,496 ± 0,018 at 10 ppm, 0,438 ± 0,008 at 20 ppm, 0,357 ± 0,003 at 30 ppm, and 0,326 ± 0,002 at 40 ppm, resulting in an IC?? value of 16,67 ppm. The ethyl acetate extract had an absorbance of 0,537 ± 0,010 at 10 ppm, 0,487 ± 0,002 at 20 ppm, 0,443 ± 0,011 at 30 ppm, 0,392 ± 0,003 at 40 ppm, and 0,383 ± 0,005 at 50 ppm, with an IC?? of 28,50 ppm ...</p> Irmatika Hendriyani Meri Kartika Maulida Abdul Rahman Wahid Widayatul Khairi Taufan Hari Sugara Copyright (c) 2025 Medical Sains : Jurnal Ilmiah Kefarmasian https://creativecommons.org/licenses/by-sa/4.0 2025-07-05 2025-07-05 10 3 263 272 10.37874/ms.v10i3.1724 COMPUTER-AIDED OPTIMIZATION OF PHYTOCHEMICAL EXTRACTION: BOX-BEHNKEN DESIGN-RESPONSE SURFACE METHODOLOGY (BBD-RSM) APPROACH TO Mimusops Elengi L. LEAVES FLAVONOIDS https://ojs.ummada.ac.id/index.php/iojs/article/view/1739 <p>Tanjung (<em>Mimusops</em> <em>elengi</em> L.) leaves contain flavonoids that exhibit antimicrobial, antifungal, and antioxidant properties. The extraction conditions must be optimized to obtain an extract with the highest flavonoid content. This study was conducted to determine the optimal extraction conditions using Response Surface Methodology (RSM). The RSM study consisted of stage I, which involved a one-factor-one-time approach to screen factors influencing the extraction and determine their levels, and stage II, which utilized the Box-Behnken Design three-level-three-factor to obtain a regression equation model. The obtained regression equation model was then tested using the Lack of Fit test, individual and simultaneous regression parameter tests, and residual assumption tests. The results of the RSM optimization were verified under optimal conditions and analyzed using a one-sample t-test at a 95% confidence level. The research results indicate that the regression equation model follows a second-order model, namely Y = 1.1623 + 0.0978X<sub>1</sub> + 0.052X<sub>1</sub>X<sub>3</sub> ? 0.0873X<sub>2</sub>X<sub>3</sub> ? 0.0111(X<sub>1</sub>)<sup>2</sup> ? 0.0915(X<sub>2</sub>)<sup>2</sup> ? 0.1145(X<sub>3</sub>)<sup>2</sup>. The optimum extraction conditions were a particle size of 354 ?m, ethanol concentration of 68%, and solvent-solid ratio of 8.5 mL/g. Verification of the optimum conditions yielded a total flavonoid content of 1.20 ± 0.03% w/w (<em>n=3</em>), which was not significantly different from the predicted result of 1.19% w/w (<em>p</em> &gt; 0.05).</p> <p><strong> </strong><strong>Keywords</strong>: <em>Mimusops elengi </em>L<em>., </em>Response Surface Methodology (RSM), Box-Behnken Design, total flavonoid</p> Fajar Aji Lumakso Gunawan Aji Pamungkas Copyright (c) 2025 Fajar Aji Lumakso, Gunawan Aji Pamungkas https://creativecommons.org/licenses/by-sa/4.0 2025-08-17 2025-08-17 10 3 273 286 10.37874/ms.v10i3.1739 MEASUREMENT OF QUALITY PARAMETERS OF SIMPLICIA AND EKSTRACT OF KECOMBRANG STEM (Etlingera elatior) https://ojs.ummada.ac.id/index.php/iojs/article/view/1752 <p>Kecombrang (<em>Etlingera elatior</em>) is a type of plant known to the Indonesian people as a medicinal plant for a long time. Kecombrang stem is empirically used to treat coughs, reduce fever, act as an antiseptic, treat diarrhoea and stomach pain. Kecombrang stem has the potential to be used as a raw material for herbal medicines. Plants used as raw materials for herbal medicines must meet quality requirements in accordance with the requirements of both specific and non-specific parameters. This study aimed to determine the quality of the simplicia and 96% ethanol extract of kecombrang stem. Simplicia and 96% ethanol extract were tested for specific parameters, including organoleptic, microscopic, and phytochemical screening. Non-specific parameter testing includes the measurement of moisture content, residual solvents, and microbial contamination. Tests of specific parameters on organoleptic kecombrang stem simplicia are light brown, aromatic odor, and tasteless. Microscopically, kecombrang stem simplicia was identified with fragments consisting of transport bundles, ladder-type transport bundles, fibers, and parenchyma with secretory cells. Phytochemical screening of kecombrang stem simplicia revealed the presence of alkaloids, phenolics, flavonoids, steroids, tannins, and saponins. The results of non-specific parameter testing on 96% ethanol extract of kecombrang stem showed 1.09% moisture content, 0.48% solvent residue, 0 CFU/g bacterial contamination, and yeast/mould. Kecombrang stem is a raw material for herbal medicine that meets the quality requirements of specific and non-specific parameters.</p> <p><strong>Keywords</strong>: <em>Etlingera</em> <em>elatior</em>, Non-specific parameters, Simplicia quality, Specific parameters.</p> Syilvi Adini Afifah Nur Shobah Pra Panca Bayu Chandra Copyright (c) 2025 Syilvi Adini, Afifah Nur Shobah, Pra Panca Bayu Chandra https://creativecommons.org/licenses/by-sa/4.0 2025-09-11 2025-09-11 10 3 287 294 10.37874/ms.v10i3.1752 ANTIBACTERIAL ACTIVITY OF JAVANESE CARDAMOMUM FRUIT ESSENTIAL OIL (Wurfbainia compacta) ON Propionibacterium acnes https://ojs.ummada.ac.id/index.php/iojs/article/view/1140 <p>Cardamom fruit contains the essential oils cineol, terpineol and borneol which have the potential to act as antibacterials against the growth of <em>Propionibacterium acnes</em>. This study aimed to determine the percentage yield of essential oil and the value of the inhibition zone for the antibacterial activity of cardamom fruit oil. The research method begins with the preparation of dried simplicia from cardamom fruit, which is then distilled using water steam. The essential oil obtained was subjected to antibacterial activity using the well diffusion method. The results of the research showed that the yield of cardamom fruit essential oil was 1,66%. Cardamom fruit simple powder contains secondary metabolite compounds alkaloids, flavonoids, saponins, steroids, triterpenoids and polyphenols. The antibacterial activity test against <em>Propionibacterium acnes</em> at concentrations of 3%, 6%, and 12% produced inhibition zones of 3.2 mm, 4.7 mm, and 10.1 mm, respectively. Therefore, it can be concluded that at concentrations of 3% and 6%, it is included in the medium category, while at a concentration of 12%, it is included in the strong category.</p> <p><strong><em>Keywords: </em></strong><em>Antibacterial, Oil of Cardamomum Fruit, Propionibacterium acnes, Wurfbainia compacta</em></p> Ali Nofriyaldi Ayu Rahmawati Sri Rezeki Nur Endah Copyright (c) 2025 Ali Nofriyaldi, Ayu Rahmawati, Sri Rezeki Nur Endah https://creativecommons.org/licenses/by-sa/4.0 2025-09-22 2025-09-22 10 3 295 302 10.37874/ms.v10i3.1140 THE EFFECTIVENESS OF BIOSYNTHESIZED ZnO NANOPARTICLES AS ANTIBACTERIALS: A LITERATURE REVIEW https://ojs.ummada.ac.id/index.php/iojs/article/view/1712 <p>One of the human infections caused by bacteria is digestive tract infection, some of these bacteria include S.typhi, E.coli, S.dysenteriae. Antibiotics are required to treat infectious diseases caused by microbes; however, most antibiotics cause resistance to these microbes. To avoid this, researchers are interested in developing plant-derived antibiotics. This review aims to evaluate the antibacterial effectiveness of ZnO nanoparticles synthesized from plant extracts or microorganisms and their antibacterial activity against gram-positive bacteria (B. Cereus &amp; S. Aureus) and gram-negative bacteria (E. Coli, K. Pneumonia &amp; S. Thypi). From this review, it can be concluded that ZnO nanoparticles have significant antibacterial activity against gram-negative bacteria. This antibacterial effectiveness is influenced by the particle size, ZnO-NPs concentration, and environmental conditions, such as pH and temperature. However, further studies are needed to determine the effectiveness of biosynthesized ZnO nanoparticles and their activities other than antibacterials.</p> <p><strong>Keywords</strong>: Zinc Oxide Nanoparticles, Nanoparticles, Antibacterial, Biosynthesis, Green Synthesi </p> Selly Nopriyanti Yani Mulyani Copyright (c) 2025 Selly Nopriyanti, Yani Mulyani https://creativecommons.org/licenses/by-sa/4.0 2025-09-29 2025-09-29 10 3 303 310 10.37874/ms.v10i3.1712 THE EFFECT OF LAVENDER OIL CONCENTRATION ON PREFERENCE AND SKIN IRRITATION OF NIGHT BODY LOTION CONTAINING NANOSTRUCTURED LIPID CARRIERS-UBIQUINONE https://ojs.ummada.ac.id/index.php/iojs/article/view/1344 <p>Lavender Oil (LO) has a calming scent and antioxidant activity. Therefore, this oil has potential as a fragrance and second active ingredient in Night Body Lotion (NBL) that contained Coenzyme Q10 (CoQ10) loaded Nanostructured Lipid Carrier (NLC) systems. This study aims to observe the effect of LO’s concentration on the physical characteristics, consumer preference level, and skin irritation of NBL that contained NLC-CoQ10. There are three formulas observed in this study, namely F0 (0% LO), F1 (2% LO), and F2 (4% LO). The physical characteristics assessed included organoleptic, homogeneity, pH, spreadability, and viscosity. In vivo skin irritation tests observe erythema and edema on the skin of a white rat. In a consumer preference test, the panelists assess the organoleptic properties of F0, F1, and F3 using a 7-point hedonic scale. Based on the physical characteristic test, it is known that the three formulas have the same color, consistency, homogeneity, and spreadability value. The difference between the three formulas lies in their aroma. F0 is unscented; F1 and F2 have a lavender scent. All formulas have a pH in the range of 5.89-6.06. Statistically, increasing the concentration of LO decreases the pH of NBL. The three formulas have a viscosity in the range of 2.140–2.890 cP. Statistically, the viscosity of NBL increased with the increase in LO concentration. Based on the skin irritation test, it is known that all formulas are non-irritating. Based on preference level analysis, the most preferred formulas based on their scent are F1 and F2.</p> Fransisca Dita Mayangsari Aditya Sindu Sakti Khusnul Khotimah Copyright (c) 2025 Fransisca Dita Mayangsari, Aditya Sindu Sakti, Khusnul Khotimah https://creativecommons.org/licenses/by-sa/4.0 2025-09-29 2025-09-29 10 3 311 320 10.37874/ms.v10i3.1344 THE POTENTIAL OF A SOOTHING GEL OF YELLOW WATERMELON (Citrullus lanatus (Thunb.) AND CUCUMBER (Cucumis sativus L.) EXTRACT COMBINATION AS SUNSCREEN https://ojs.ummada.ac.id/index.php/iojs/article/view/588 <p>People, particularly women with dry skin issues, want to apply sunscreen and skincare products to moisturize their skin. As a matter of fact, a formulation, that functions to moisturize is a soothing gel. A soothing gel formulation requires an active substance with a high water content, which can be obtained from fruits such as cucumbers and yellow watermelons. This study aimed to explore the potential of a soothing gel containing yellow watermelon and cucumber extract as a sunscreen, based on its Sun Protection Factor (SPF) value. Moreover, in this study, the yellow watermelon and cucumber extracts were processed using a juicer. Subsequently, a flavonoid test was conducted on the extract combination. The combination of yellow watermelon and cucumber extracts was formulated into a soothing gel at concentrations of 70%, 80%, and 90%. Furthermore, the SPF value of the soothing gel was determined in vitro using the UV-Vis spectrophotometry method. The results of this study showed that yellow watermelon and cucumber extracts, as well as their combination, contained flavonoid compounds. The highest SPF value, namely that of the soothing gel formula, was 80%. The SPF value of soothing gel formula 70%, 80%, and 90% respectively, was 3.5118±0.1969; 4.3771±0.4184; and 3.2274±0.2397. Hence, it can be concluded that, based on the SPF value, the combination of yellow watermelon and cucumber extracts in the soothing gel has potential as a sunscreen with medium protection.</p> <p><strong><em>Keywords</em></strong><em>: Citrullus lanatus </em>Thunb., <em>Cucumis sativus </em>L.<em>, yellow watermelon, soothing gel, sun protection factor</em></p> Anisa Lailatusy Syarifah Yunita Ressa Marisa Chintya Ferda Intansari Copyright (c) 2025 Anisa Lailatusy Syarifah, Yunita, Ressa Marisa, Chintya Ferda Intansari https://creativecommons.org/licenses/by-sa/4.0 2025-09-29 2025-09-29 10 3 321 334 10.37874/ms.v10i3.588 ANALYSIS OF THE EFFECTIVENESS OF NATURAL INGREDIENTS IN ANTHYPERURICEMIA:REVIEW https://ojs.ummada.ac.id/index.php/iojs/article/view/1322 <p><strong>Introduction:</strong> Hyperuricemia is characterized by increased uric acid levels in the blood due to excessive production or impaired excretion. In Indonesia, the hyperuricemia rate reaches 18% of the total population. <strong>Objective:</strong> This study aimed to explore and analyze the potential of medicinal plants with antihyperuricemic activity in reducing uric acid levels in patients with hyperuricemia and experimental animals. <strong>Materials and Methods </strong>A total of 21 scientific articles were reviewed, focusing on the treatment of hyperuricemia using natural ingredients. Data were obtained from the Google Scholar and PubMed databases using keywords such as “hyperuricemia,” “medicinal plants,” and “natural therapy.” The inclusion criteria were articles published within the last 10 years that involved in vitro and in vivo models. <strong>Results:</strong> The review identified several natural ingredients, including turmeric, kepel leaves, and mangosteen peel, which demonstrated significant antihyperuricemic effects. These ingredients were effective in reducing uric acid levels in both animal and human studies.<strong>Conclusion: </strong>Natural ingredients show promising potential as alternative treatments for hyperuricemia by inhibiting xanthine oxidase activity. However, further clinical trials are required to validate these findings and support their application in therapeutic practice.</p> <p><strong>Keywords:</strong> Antihyperuricemia, Uric Acid, Natural Ingredients, Clinical Trials</p> Elva Angela Susanti Diniatik Copyright (c) 2025 Elva Angela, Susanti, Diniatik https://creativecommons.org/licenses/by-sa/4.0 2025-09-30 2025-09-30 10 3 335 344 10.37874/ms.v10i3.1322 OPTIMIZATION TYPE OF STIFFENING AGENT IN FORMULATION CREAM Melastoma malabathricum L. LEAF WATER FRACTION https://ojs.ummada.ac.id/index.php/iojs/article/view/1607 <p>The skin is one of the visible outer parts of the body, and cosmetics are used for its care. Senggani (<em>Melastoma malabathricum</em>) leaves contain flavonoids, saponins, alkaloids, tannins, and polyphenols. The polyphenol content found in M. malabathricum leaves has high antioxidant activity and has the potential to be used as a sunscreen that can block the negative effects of UVA and UVB rays. These secondary metabolites can be obtained from the water fraction and used as antioxidants in cream preparations. Cream formulations require compounds that can maintain the consistency of the preparation to produce good physical properties and stability. This study aimed to analyze the type of stiffening agent in the formulation of cream preparation of aqueous fraction of senggani leaf (<em>Melastoma malabathricum</em> L.) using organoleptical tests, homogeneity, pH, spreadability, adhesiveness, and viscosity of cream preparation. The results showed that cetyl alcohol (FII) has different physical properties, and the evaluation and accelerated stability test (cycling test) resulted in the most physically stable preparation, as evidenced by the sig. (p value) &gt; 0.05, indicating that storage did not affect the cream preparation.</p> <p><strong> </strong><strong>Keywords</strong>: senggani leaf (<em>Melastoma malabathricum</em> L.), water fraction, cream, cycling test</p> Raden Hasya Nadhira Desy Siska Anastasia Pratiwi Apridamayanti Meri Ropiqa Copyright (c) 2025 Raden Hasya Nadhira, Desy Siska Anastasia, Pratiwi Apridamayanti, Meri Ropiqa https://creativecommons.org/licenses/by-sa/4.0 2025-09-30 2025-09-30 10 3 345 356 10.37874/ms.v10i3.1607 DESIGN AND OPTIMIZATION OF VCO AND OLEIC ACID FOR NLC QUERCETIN USING SIMPLE LATTICE DESIGN https://ojs.ummada.ac.id/index.php/iojs/article/view/1747 <p>Quercetin is a flavonoid compound that exhibits skin-brightening activity by inhibiting tyrosinase. However, its topical application is limited because of its low solubility. A Nanostructured Lipid Carrier (NLC) was selected as the delivery system to enhance the stability and topical efficacy of quercetin. This study aimed to optimize the combination ratio of oleic acid and Virgin Coconut Oil (VCO) as the liquid lipid phase in the NLC Blank Formulation using the Simplex Lattice Design (SLD) method. Eight blank NLC formulations were prepared using the high-shear homogenization method and were evaluated based on organoleptic properties, particle size, polydispersity index (PDI), pH, and real-time stability over 30 days. Eight blank NLC Blank Formulations showed that a balanced VCO to oleic acid ratio (5.5:4.5) produced small particle sizes (&lt;160 nm), low polydispersity index (PDI &lt;0.25), and good physical stability. Blank Formulations dominated by either VCO or oleic acid tended to have larger particles and lower stability, indicating that the liquid lipid ratio influenced the NLC characteristics. Optimization using the Simplex Lattice Design (SLD) method identified three optimal lipid ratios: B1 (4.86:5.31), B2 (2:8), and B3 (9:1), each with desirability values near 1. The model was validated by comparing the predicted (dry lab) and experimental (wet lab) data, which showed no significant differences in key parameters (p &gt; 0.05), confirming the reliability of the SLD model. This approach effectively optimized quercetin-loaded NLC Blank Formulations, and the three selected Blank Formulas serve as a strong basis for developing topical quercetin NLC products.</p> Definta Anisa Tamara Cahyono Noorma Rosita Tristiana Erawati Copyright (c) 2025 Definta Anisa Tamara Cahyono, Noorma Rosita, Tristiana Erawati https://creativecommons.org/licenses/by-sa/4.0 2025-09-30 2025-09-30 10 3 357 366 10.37874/ms.v10i3.1747 PHYTOCHEMICAL PROFILING OF PURNAJIWA FRUIT (Kopsia arborea Blume.) EXTRACTS AND ANTIBACTERIAL ACTIVITY AGAINST METHICILLIN-RESISTANT Staphylococcus aureus (MRSA) https://ojs.ummada.ac.id/index.php/iojs/article/view/1767 <p>Purnajiwa (<em>Kopsia arborea</em> Blume.) contains diverse phytochemicals with notable antibacterial potential. This study aimed to characterize and quantify the phytochemicals of <em>Kopsia arborea</em> fruit extracts obtained by maceration and Soxhlet extraction with methanol and evaluate their antibacterial activity against MRSA through phytochemical screening, GC-MS analysis, spectrophotometric quantification of flavonoids, alkaloids, and phenolics, and disc diffusion assay at 100 ?g/mL concentration. The findings indicated that the Soxhlet extraction produced a superior yield (19.47 ± 0.58%) compared to maceration (11.09 ± 0.65%). Phytochemical analysis revealed the presence of alkaloids, flavonoids, phenolics, tannins, saponins, and triterpenoids, with no qualitative differences between the two extracts. Quantitative analysis demonstrated higher concentrations of alkaloids, flavonoids, and phenolics in the Soxhlet extract, with values of 88.58 ± 3.76, 46.50 ± 1.04, and 57.87 ± 0.44 ?g/mL, respectively, compared to the maceration extract (50.46 ± 3.86, 26.22 ± 0.27, and 30.49 ± 0.31 ?g/mL, respectively). GC-MS analysis identified 13 alkaloid compounds in the Soxhlet extract and 12 in the maceration extract. Antibacterial assays revealed that the mean inhibition zone diameter against MRSA was 11.69 ± 0.28 mm for the Soxhlet extract and 12.61 ± 0.27 mm for the maceration extract, respectively. In conclusion, Soxhlet extraction yielded higher concentrations of alkaloids, phenolic compounds, and flavonoids; however, GC-MS analysis revealed that the macerated extract exhibited a higher AUC of alkaloid compounds than that of Soxhlet extraction. Moreover, the macerated extract demonstrated superior antibacterial activity, indicating that maceration has greater potential for development as an antibacterial agent than Soxhlet extraction.</p> Maria Malida Vernandes Sasadara Erna Cahyaningsih Putu Era Sandhi Kusuma Yuda Ni Luh Putri Apriliani Ni Kadek Dwi Purnama Dewi Copyright (c) 2025 Maria Malida Vernandes Sasadara, Erna Cahyaningsih, Putu Era Sandhi Kusuma Yuda, Ni Luh Putri Apriliani, Ni Kadek Dwi Purnama Dewi https://creativecommons.org/licenses/by-sa/4.0 2025-09-30 2025-09-30 10 3 367 378 10.37874/ms.v10i3.1767 DETERMINANTS OF MEDICATION ADHERENCE AMONG CHRONIC DISEASE PATIENTS IN YOGYAKARTA: STRUCTURAL EQUATION MODELING (PLS-SEM) APPROACH https://ojs.ummada.ac.id/index.php/iojs/article/view/1780 <p>Chronic diseases are a major global health challenge and remain a leading cause of morbidity and mortality in Indonesia. Sustained adherence to long-term pharmacological therapy is essential but is often suboptimal. This study aimed to analyze the determinants of medication adherence among patients with chronic diseases at RSUD Kota Yogyakarta using structural equation modeling-partial least squares (SEM-PLS). A cross-sectional survey was conducted between January and February 2025 with 120 purposively selected outpatients. Medication adherence was assessed using the Adherence to Refills and Medications Scale (ARMS) and additional questionnaires measuring therapeutic regimens, patient perceptions, socioeconomic factors, and healthcare system attributes. Data were analyzed using SmartPLS 4. The results showed that 74.2% of patients had low adherence and 25.8% had moderate adherence, with none achieving high adherence. SEM-PLS analysis indicated that therapy complexity (?=0.262, p&lt;0.01), patient perception (?=0.381, p&lt;0.01), socioeconomic status (?=0.265, p&lt;0.01), and healthcare system support (?=0.199, p&lt;0.01) were significant predictors, explaining 66% of adherence variance (R²=0.660). In conclusion, medication adherence among patients with chronic diseases in Yogyakarta was low and was strongly influenced by regimen burden, perception, socioeconomic status, and healthcare support. Targeted interventions addressing these factors are essential for improving adherence and long-term health outcomes.</p> <p><strong> </strong><strong>Keywords</strong>: chronic disease, therapy adherence, ARMS, SEM-PLS, Yogyakarta</p> Mega Octavia Muhammad Azwir Al Abrar Muhammad Thesa Ghozali Copyright (c) 2025 Mega Octavia, Muhammad Azwir Al Abrar, Muhammad Thesa Ghozali https://creativecommons.org/licenses/by-sa/4.0 2025-09-30 2025-09-30 10 3 379 388 10.37874/ms.v10i3.1780