Conclusions
This comprehensive meta-analysis of non-adherence to anti-diabetic medications documented a higher proportion of medication non-adherence among individuals with diabetes in LMIC settings when MMAS-8 item scale was used and low when MMAS-4 and the 80-90% cut-off scales were used. Various factors, such as disease factors, therapy-related factors, healthcare system factor, patient-centered factors, and socio-economic factors contributed to non-adherence. Therefore, multifaceted intervention is needed to create supportive environment for individuals to combat medication non-adherence. Furthermore, given that diabetes is easily controlled by adherence to medication, it is essential to provide trainings and interventional programmes to increase adherence rates in affected individuals.