Background: Medication adherence among older adults with chronic diseases is influenced by clinical, behavioral, psychosocial, and spiritual factors. However, structured health education integrating Islamic spiritual values remains limited in Indonesia. Purpose: This study aimed to evaluate changes in spirituality and medication adherence following an Islamic health education intervention and to explore participants’ experiences of the intervention. Methods: A sequential explanatory mixed-methods design was used, consisting of a single-group pretest–posttest quantitative phase followed by a qualitative phase. The study involved 158 Muslim adults aged ≥60 years with chronic diseases at PKU Muhammadiyah Hospital Temanggung, Indonesia. Spirituality and medication adherence were assessed using the daily spiritual experience scale (DSES) and the eight-item morisky medication adherence scale (MMAS-8), respectively. Sixteen participants were subsequently selected for in-depth interviews. Results: The mean DSES score increased from 48.72±7.84 to 57.91±6.45 (mean difference=9.19; 95% CI: 8.38–10.00; p<0.001; Cohen’s d=1.79). The median MMAS-8 score increased from 5 (IQR: 4–6) to 7 (IQR: 6–8; p<0.001; r=0.28). Qualitative findings indicated that the integration of Islamic values strengthened spiritual meaning, emotional calmness, motivation, and discipline in medication-taking. However, forgetfulness, treatment fatigue, physical limitations, and dependence on family support remained barriers to medication adherence. Conclusion: The Islamic health education module was associated with improvements in spirituality and medication adherence among older adults with chronic diseases.
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