Hubungan Karakteristik, Kepatuhan, dan Outcome Klinis Pasien Tuberkulosis Paru Di Puskesmas Kabupaten Bantul

https://doi.org/10.22146/farmaseutik.v17i2.60681

Muh Irham Bakhtiar(1), Chairun Wiedyaningsih(2), Nananng Munif Yasin(3), Susi Ari Kristina(4*)

(1) Fakultas Farmasi, Universitas Gadjah Mada
(2) Fakultas Farmasi, Universitas Gadjah Mada
(3) Fakultas Farmasi, Universitas Gadjah Mada
(4) Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Tuberkulosis (TB) merupakan penyakit menular yang disebabkan oleh Mycobacterium tuberculosis. Berdasarkan Hasil Profil Kesehatan Kabupaten Bantul Provinsi Daerah Istimewa Yogyakarta (DIY) tahun 2017, keberhasilan terapi tuberkulosis sebesar 65% dalam hal ini berada dalam posisi terendah dan dibawah target minimal 85% (secara nasional). Angka keberhasilan pengobatan penyakit TB erat kaitannya dengan kepatuhan pengobatan. Berdasarkan laporan WHO 2019 Angka putus berobat pada pasien TB dindonesia 26%. Angka putus berobat ini sangat berbahaya karena jika pengobatan tidak dilakukan secara teratur akan memberikan outcome klinis yang buruk bahkan target nasional adalah tidak boleh melebih >10 %. Tujuan penelitian ini yaitu melihat gambaran pengetahuan pasien TB  Paru, mengetahui gambaran kepatuhan pengobatan dan melihat hubungan antara kepatuhan pengobatan terhadap outcome klinis. Penelitian ini merupakan penelitian observasional analitik dengan rancangan studi cross sectional yang dilakukan di wilayah Kabupaten Bantul tersebar di 15 Puskesmas pada periode Maret-Juni 2020. Alat ukur kepatuhan pengobatan menggunakan kuesioner Morisky Green Levine Test (MGLT). Total subyek dalam penelitian ini adalah 57 responden dari populasi yang memenuhi kriteria inklusi dan ekslusi penelitian. Semua responden mimiliki pengetahuan yang tinggi (>5) baik pada pasien patuh maupun tidak patuh. Gambaran kepatuhan pengobatan TB paru bahwa terdapat 51 (89,5%) responden patuh dalam pengobatan dengan menjawab “ Tidak” pada 4 pertanyaan dalam Kuesioner MGLT dan terdapat 6 (10,5%) responden yang tidak patuh dalam pengobatan TB paru dengan jawaban yang beragam mulai dari bahwa responden merasa tidak membaik sebanyak 60%, beralasan lupa sebanyak 33%, karena lalai dalam pengobatan 16% responden dan karena merasa dirinya membaik 16%. Hubungan antara kepatuhan pengobatan dengan outcome klinis pasien tuberkulosis paru tidak ada perbedaan signifikan secara statistik dikarenakan outcome klinis membaik pada kelompok patuh maupun tidak patuh.

Kata Kunci : Kepatuhan Pengobatan, Outcome Klinis, TB-Paru, MGLT

Keywords


Kepatuhan Pengobatan; Outcome Klinis; TB-Paru; MGLT

Full Text:

PDF


References

Al-Hajjaj & Al-Khatim 2000. High rate of non-compliance with anti-tuberculosis treatment despite a retrieval system: a call for implementation of directly observed therapy in Saudi Arabia. The International Journal of Tuberculosis and Lung Disease, 4, 345-349. 2. Altet, Latorre, Jiménez-Fuentes, Maldonado, Molina, González-Díaz, Milà, García-García, Muriel & Villar-Hernández 2017. Assessment of the influence of direct tobacco smoke on infection and active TB management. PloS one, 12, e0182998. 3. Azarkar, Sharifzadeh, Ebrahimzadeh & Olumi 2016. Time to sputum smear conversion in smear-positive pulmonary tuberculosis patients and factors for delayed conversion. Iranian journal of medical sciences, 41, 44. 4. Balasubramanian, Oommen & Samuel 2000. DOT or not? Direct observation of anti-tuberculosis treatment and patient outcomes, Kerala State, India. The International Journal of Tuberculosis and Lung Disease, 4, 409-413. 5. Al-Hajjaj & Al-Khatim 2000. High rate of non-compliance with anti-tuberculosis treatment despite a retrieval system: a call for implementation of directly observed therapy in Saudi Arabia. The International Journal of Tuberculosis and Lung Disease, 4, 345-349. 6. Altet, Latorre, Jiménez-Fuentes, Maldonado, Molina, González-Díaz, Milà, García-García, Muriel & Villar-Hernández 2017. Assessment of the influence of direct tobacco smoke on infection and active TB management. PloS one, 12, e0182998. 7. Azarkar, Sharifzadeh, Ebrahimzadeh & Olumi 2016. Time to sputum smear conversion in smear-positive pulmonary tuberculosis patients and factors for delayed conversion. Iranian journal of medical sciences, 41, 44. 8. Balasubramanian, Oommen & Samuel 2000. DOT or not? Direct observation of anti-tuberculosis treatment and patient outcomes, Kerala State, India. The International Journal of Tuberculosis and Lung Disease, 4, 409-413. 9. Balbay, Annakkaya, Arbak, Bilgin & Erbas 2005. Which patients are able to adhere to tuberculosis treatment? A study in a rural area in the northwest part of Turkey. Japanese Journal of Infectious Diseases, 58, 152. 10. Bates, Khalakdina, Pai, Chang, Lessa & Smith 2007. Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Archives of internal medicine, 167, 335-342. Becker MA & Fernando Perez-Ruiz 2019. Pharmacologic urate-lowering therapy and treatment of tophi in patients with gout. Post TW, ed. UpToDate. 11. Bernabe-Ortiz, Carcamo, Sanchez & Rios 2011. Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis. PloS one, 6, e18474. 12. Bhatia, Dranyi & Rowley 2002. Tuberculosis among Tibetan refugees in India. Social science & medicine, 54, 423-432. 13. Boru, Shimels & Bilal 2017. Factors contributing to non-adherence with treatment among TB patients in Sodo Woreda, Gurage Zone, Southern Ethiopia: A qualitative study. Journal of infection and public health, 10, 527-533. 14. Chen, Du, Wu, Xu, Ji, Zhang, Zhu & Zhou 2020. The effects of family, society and national policy support on treatment adherence among newly diagnosed tuberculosis patients: a cross-sectional study. 15. Contrerasa, Guillénb, Martíneza, Clarosc, von Wichmannd, de Pablosa, Martíne, Garcíaf & Garcíag 2006. Análisis de los estudios publicados sobre el incumplimiento terapéutico en el tratamiento de la hipertensión arterial en España entre los años 1984 y 2005. Aten Primaria, 38, 325-32. 16. Control & Prevention 2015. Reported tuberculosis in the United States, 2014. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. 17. Control, Prevention & Committee 2013. Transmission and pathogenesis of tuberculosis. Core Curriculum to Tuberculosis, 19-44. 18. Danso, Addo & Ampomah 2015. Patients’ compliance with tuberculosis medication in Ghana: evidence from a periurban community. Advances in Public Health, 2015. 19. Dewi, Hakim, Sismindan, Ngatidjan & Putra 2019. Gambaran Reaksi Obat Yang Tidak Dikehendaki pada Pengobatan Tuberkulosis di Puskesmas Kabupaten “X” Yogyakarta dan Hubungannya dengan Kepatuhan Minum Obat. Majalah Farmasetika, 4, 132-136. 20. DIY 2019. Profil Kesehatan Provinsi Daerah Istimewa Yogyakarta. 21. Ephrem, Mengiste, Mesfin & Godana 2015. Determinants of active pulmonary tuberculosis in Ambo Hospital, West Ethiopia. African journal of primary health care & family medicine, 7, 1-8. 22. Ernawati & Islamiyah 2019. UJI VALIDITAS DAN RELIABILITAS KUESIONER KEPATUHAN MGLS (MORISKY, GREEN, LEVINE ADHERENCE SCALE) VERSI BAHASA INDONESIA TERHADAP PASIEN EPILEPSI. Jurnal Ilmiah Ibnu Sina, 4, 305-313. 23. Fagundez, Perez-Freixo, Eyene, Momo, Biyé, Esono, Ondó Mba Ayecab, Benito, Aparicio & Herrador 2016. Treatment adherence of tuberculosis patients attending two reference units in Equatorial Guinea. PloS one, 11, e0161995. 24. Fang, Shen, Hu, Xu, Jun, Zhang, Kan, Ma & Wu 2019. Prevalence of and Factors Influencing Anti-Tuberculosis Treatment Non-Adherence Among Patients with Pulmonary Tuberculosis: A Cross-Sectional Study in Anhui Province, Eastern China. Medical science monitor: international medical journal of experimental and clinical research, 25, 1928. 25. Feng, Huang, Ting, Chen, Lin, Huang, Lin, Hwang, Lee & Yu 2012. Gender differences in treatment outcomes of tuberculosis patients in Taiwan: a prospective observational study. Clinical Microbiology and Infection, 18, E331-E337. 26. Field 2001. Tuberculosis in the workplace, National Academies Press. 27. Fitzgerald, Sterling & Haas 2015. Mycobacterium tuberculosis In: Mandell GL, Bennets JE, Dolin R. Principles and practice of infectious disease. Philadelphia, Elsevier Churchill Livingstone. 28. Gebreweld, Kifle, Gebremicheal, Simel, Gezae, Ghebreyesus, Mengsteab & Wahd 2018. Factors influencing adherence to tuberculosis treatment in Asmara, Eritrea: a qualitative study. Journal of Health, Population and Nutrition, 37, 1. 29. Geetakrishnan 1990. Case holding and treatment failures under a TB clinic operating in rural settings. Int J Tub, 37, 145-8. 30. Gube, Debalkie, Seid, Bisete, Mengesha, Zeynu, Shimelis & Gebremeskel 2018. Assessment of anti-TB drug nonadherence and associated factors among TB patients attending TB clinics in Arba Minch Governmental Health Institutions, Southern Ethiopia. Tuberculosis research and treatment, 2018. 31. Herrero, Ramos & Arrossi 2015. Determinants of non adherence to tuberculosis treatment in Argentina: barriers related to access to treatment. Revista Brasileira de Epidemiologia, 18, 287-298. 32. Hoa, Lauritsen & Rieder 2013. Changes in body weight and tuberculosis treatment outcome in Viet Nam. The International Journal of Tuberculosis and Lung Disease, 17, 61-66. 33. Huaman, Henson, Ticona, Sterling & Garvy 2015. Tuberculosis and cardiovascular disease: linking the epidemics. Tropical diseases, travel medicine and vaccines, 1, 1-7. 34. Huddart, Bossuroy, Pons, Baral, Pai & Delavallade 2018. Knowledge about tuberculosis and infection prevention behavior: A nine city longitudinal study from India. PloS one, 13. 35. Hussein, Yousef & Abusedera 2013. Pattern of pulmonary tuberculosis in elderly patients in Sohag Governorate: hospital based study. Egyptian Journal of Chest Diseases and Tuberculosis, 62, 269-274. 36. Jeon & Murray 2008. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS med, 5, e152. 37. Jiménez-Corona, Cruz-Hervert, García-García, Ferreyra-Reyes, Delgado-Sánchez, Bobadilla-del-Valle, Canizales-Quintero, Ferreira-Guerrero, Báez-Saldaña & Téllez-Vázquez 2013. Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes. Thorax, 68, 214-220. 38. Jimmy & Jose 2011. Patient medication adherence: measures in daily practice. Oman medical journal, 26, 155. Kaplan, Benson, Holmes, Brooks, Pau, Masur, Control, Prevention, 39. Health & America 2009. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. MMWR Recomm Rep, 58, 1-207. 40. Kemenkes 2014. Pedoman nasional pengendalian tuberkulosis. Kementerian Kesehatan RI. 41. Kemenkes 2016. Peraturan Menteri Kesehatan Republik Indonesia Nomor 67 Tahun 2016 tentang Penanggulangan Tuberkulosis. Jakarta: Kemenkes RI. 42. Khanna, Fitzgerald, Khanna, Bae, Singh, Neogi, Pillinger, Merill, Lee & Prakash 2012. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis care & research, 64, 1431-1446. 43. Kulkarni, Akarte, Mankeshwar, Bhawalkar, Banerjee & Kulkarni 2013. Non. Adherence of New Pulmonary Tuberculosis Patients to Anti. Tuberculosis Treatment. Annals of medical and health sciences research, 3, 67-74. 44. lexicomp 2020 UpToDate-a. Adverse Reactions Pyrazinamide/Lexi Drugs Multinational. 45. Lexicomp 2020 UpToDate-b. Dosing Periperal Neuropathy Associated with Isoniasid Therapy For Mycobacterium uberculosis (prevention) 46. Lexicomp 2020 UpToDate-c. Dosisng Allopurinol gout, treatment (chronic urate-lowering Therapy). 47. Lin, Ezzati, Chang & Murray 2009. Association between tobacco smoking and active tuberculosis in Taiwan: prospective cohort study. American journal of respiratory and critical care medicine, 180, 475-480. 48. Lin, Ezzati & Murray 2007. Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS med, 4, e20. 49. Marais, Lönnroth, Lawn, Migliori, Mwaba, Glaziou, Bates, Colagiuri, Zijenah & Swaminathan 2013. Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts. The Lancet infectious diseases, 13, 436-448. 50. McNamara, Normand & Whelan 2013. Patterns and determinants of health care utilisation in Ireland. 51. Mekonnen & Azagew 2018. Non-adherence to anti-tuberculosis treatment, reasons and associated factors among TB patients attending at Gondar town health centers, Northwest Ethiopia. BMC research notes, 11, 691. 52. Mohamed, Kanagasabapathy & Kalifulla 2015. Socio-economic profile and risk factors among pulmonary tuberculosis patients in 53. Madurai, India: a cross sectional study. International Journal of Research in Medical Sciences, 3, 3490-8. 54. Nahid, Dorman, Alipanah, Barry, Brozek, Cattamanchi, Chaisson, Chaisson, Daley & Grzemska 2016. Official American thoracic society/centers for disease control and prevention/infectious diseases society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis. Clinical Infectious Diseases, 63, e147-e195. 55. Ncube, Takarinda, Zishiri, Van den Boogaard, Mlilo, Chiteve, Siziba, Trinchán & Sandy 2017. Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable? Public health action, 7, 212-217. 56. Obuku, Meynell, Kiboss-Kyeyune, Blankley, Atuhairwe, Nabankema, Jeffrey & Ndungutse 2012. Socio-demographic determinants and prevalence of Tuberculosis knowledge in three slum populations of Uganda. BMC public health, 12, 536. 57. Osterberg & Blaschke 2005. Adherence to medication. New England Journal of Medicine, 353, 487-497. 58. PDPI 2006. Pedoman diagnosis dan penatalaksanaan tuberkulosis di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia. 59. Richette, Doherty, Pascual, Barskova, Becce, Castaneda-Sanabria, Coyfish, Guillo, Jansen & Janssens 2017. 2016 updated EULAR evidence-based recommendations for the management of gout. Annals of the rheumatic diseases, 76, 29-42. 60. Rieder 1996. Sputum smear conversion during directly observed treatment for tuberculosis. Tubercle and Lung Disease, 77, 124-129. 61. Rocsanna Namdar & Peloquin 2019. Tuberculosis. In: Marie A. Chisholm-Burns, Terry L. Schwinghammer, Patrick M. Malone, Jill M. Kolesar, P. Brandon Bookstaver & Kelly C. Lee (eds.) 62. Pharmacotherapy Principles & Practice. McGraw-Hill Education. 63. Rodríguez-Iturbe, Pons, Quiroz, Lanaspa & Johnson 2014. Autoimmunity in the pathogenesis of hypertension. Nature Reviews Nephrology, 10, 56. 64. Ross, Pittman & Koo 2002. Strategy for the treatment of noncompliant hypertensive hemodialysis patients. The International journal of artificial organs, 25, 1061-1065. 65. Seegert, Rudolf, Wejse & Neupane 2017. Tuberculosis and hypertension—a systematic review of the literature. International Journal of Infectious Diseases, 56, 54-61. 66. Slama, Chiang, Enarson, Hassmiller, Fanning, Gupta & Ray 2007. Tobacco and tuberculosis: a qualitative systematic review and meta-analysis. The International Journal of Tuberculosis and 67. Lung Disease, 11, 1049-1061. Smith, Van Den Eeden, Baxter, Shan, Van Rie, Herring, Richardson, Emch & Gammon 2015. Cigarette smoking and pulmonary tuberculosis in northern California. J Epidemiol Community Health, 69, 568-573. 68. Susilayanti, Medison & Erkadius 2014. Profil Penderita Penyakit Tuberkulosis Paru BTA Positif yang Ditemukan di BP4 Lubuk Alung periode Januari 2012–Desember 2012. Jurnal Kesehatan Andalas, 3. 69. Tekle, Mariam D & Ali 2002. Defaulting from DOTS and its determinants in three districts of Arsi Zone in Ethiopia. The International Journal of Tuberculosis and Lung Disease, 6, 573-579. 70. Tesfahuneygn, Medhin & Legesse 2015. Adherence to Anti-tuberculosis treatment and treatment outcomes among tuberculosis patients in Alamata District, northeast Ethiopia. BMC research notes, 8, 503. 71. Tirtana & Musrichan 2011. Faktor-faktor yang mempengaruhi keberhasilan pengobatan pada pasien tuberkulosis paru dengan resistensi obat tuberkulosis di wilayah Jawa Tengah. 72. Val, Amorós, Martínez, Fernández & León 1992. Descriptive study of patient compliance in pharmacologic antihypertensive treatment and validation of the Morisky and Green test. Atencion primaria, 10, 767. 73. van den Hof, Najlis, Bloss & Straetemans 2010. A systematic review on the role of gender in tuberculosis control. KNCV Tuberculosis Foundation. 74. WHO 2019. Global Tuberculosis Report 2019. Geneva. Xu, Lu, Zhou, Zhu, Shen & Wang 2009. Adherence to anti-tuberculosis treatment among pulmonary tuberculosis patients: a qualitative and quantitative study. BMC health services research, 9, 169. 75. Zegeye, Dessie, Wagnew, Gebrie, Islam, Tesfaye & Kiross 2019. Prevalence and determinants of anti-tuberculosis treatment non-adherence in Ethiopia: A systematic review and meta-analysis. PloS one, 14, e0210422. 76. Zhang, Cheng, Luo & Zhang 2017. Factors Affecting the Incidence of Tuberculosis and Measures for Control and Prevention. In: Lu, Y., Wang, L., Duanmu, H., Chanyasulkit, C., Strong, A. J. & Zhang, H. (eds.) Handbook of Global Tuberculosis Control. Springer. 77. Zhou, Chu, Liu, Tobe, Gen, Wang, Zheng & Xu 2012. Adherence to tuberculosis treatment among migrant pulmonary tuberculosis patients in Shandong, China: a quantitative survey study. PloS one, 7, e52334.



DOI: https://doi.org/10.22146/farmaseutik.v17i2.60681

Article Metrics

Abstract views : 6367 | views : 10469

Refbacks

  • There are currently no refbacks.


Majalah Farmaseutik Indexed by:

   
 
 
 
web analytics 
 
 
Creative Commons Licence
 
 
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.