Medication non-adherence is one of the major challenges among patients with schizophrenia. Non-adherent behavior increases the risk of relapse and hospital readmission. Medication adherence in patients with schizophrenia is influenced by various factors, which may be affected by the patient's living environment, including the characteristics of urban communities. This study aimed to describe medication adherence among patients with schizophrenia living in urban community settings. This study employed a quantitative descriptive design. The study population consisted of patients with schizophrenia residing within the service areas of community health centers in Gorontalo City. A proportionate stratified sampling technique based on community health center service areas was used to select a sample of 138 respondents. The research instruments included a demographic characteristics questionnaire and the Medication Adherence Rating Scale (MARS) for psychosis to assess medication adherence. Of the total respondents, 62.3% demonstrated low medication adherence, while 37.7% demonstrated high adherence. Demographic characteristics indicated that the majority of respondents were male (64.7%), with the largest age group being 18–39 years (57.2%). Most respondents had completed senior high school education (73.9%), were unemployed (69.9%), had household incomes below the regional minimum wage (57.2%), were prescribed atypical antipsychotic medications (63.0%), and more than half of the respondents (59.4%) were smokers.The findings indicate that medication adherence among patients with schizophrenia living in urban areas remains low. Healthcare professionals are encouraged to strengthen patient and family education, provide counseling, and conduct regular monitoring of medication adherence to improve treatment outcomes and enhance therapeutic success
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