Pharmaceutical Care Contributes to Tuberculosis Treatment Adherence and Drug Safety in Indonesia: A Systematic Review

Tuberculosis (TB) remains a major public health challenge in Indonesia, where long-term therapy is complicated by non-adherence and adverse drug events. Patient-centered pharmaceutical care—encompassing counseling, education, monitoring, and medication review—aims to address these therapeutic obstacles. This systematic review evaluated how pharmaceutical care contributes to medication adherence and drug safety among TB patients in Indonesia. Guided by PRISMA 2020, comprehensive searches were conducted across PubMed and Google Scholar (January 2014–June 2026) using Medical Subject Headings (MeSH) and tailored keywords. Primary Indonesian studies investigating pharmacist interventions and reporting adherence, adverse drug reactions (ADRs), or drug-related problems (DRPs) were included. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools. The synthesis included 15 studies across diverse healthcare settings. Ten studies (66.7%) showed that pharmacist-led counseling, education, and monitoring significantly improved medication adherence (e.g., proportion of days covered and MMAS scores). DRPs affected up to 84.34% of patients, predominantly involving drug interactions and hepatotoxicity, with ADRs identified as a primary driver of treatment default. Categorical analyses across quasi-experimental, cohort, and cross-sectional designs confirmed that structured pharmaceutical care enhances treatment compliance and safety surveillance. In conclusion, integrating pharmacists into national TB control programs (DOTS/Puskesmas) is essential to reduce preventable DRPs and optimize therapeutic success.