Pengukuran Tingkat Kepatuhan Pengobatan Pasien Hipertensi di Fasilitas Kesehatan Tingkat Pertama di Kota Bandung

Rano K. Sinuraya; Dika P. Destiani; Irma M. Puspitasari; Ajeng Diantini

doi:10.15416/ijcp.2018.7.2.124

Pengukuran Tingkat Kepatuhan Pengobatan Pasien Hipertensi di Fasilitas Kesehatan Tingkat Pertama di Kota Bandung

Rano K. Sinuraya, Dika P. Destiani, Irma M. Puspitasari, Ajeng Diantini

Abstract

Hipertensi merupakan salah satu penyakit dengan angka mortalitas dan morbiditas yang sangat tinggi di dunia. Prevalensi hipertensi semakin meningkat setiap tahunnya dan Jawa Barat berada di peringkat keempat dengan prevalensi 29,4%. Penelitian ini bertujuan untuk mengukur tingkat kepatuhan pasien hipertensi terhadap pengobatanya dengan menggunakan kuesioner Eight-Item Morisky Medication Adherence Scale (MMAS-8). Studi ini merupakan penelitian observasional menggunakan rancangan potong lintang, dilakukan pada bulan Oktober 2017–Februari 2018 di fasilitas kesehatan tingkat pertama di Kota Bandung. Sejumlah dua ratus dua puluh enam responden terlibat dalam penelitian ini. Responden mengisi mengisi kuesioner MMAS-8 versi Bahasa Indonesia yang telah divalidasi setelah menandatangani informed consent terlebih dahulu. Hasil penelitian menunjukkan bahwa sebanyak 53,5% dari responden memiliki tingkat kepatuhan rendah, 32,3% dari responden memiliki tingkat kepatuhan sedang, dan 14,2% dari responden memiliki tingkat kepatuhan tinggi. Data kemudian diolah secara statistik menggunakan analisis Chi-Square sehingga diperoleh hasil bahwa terdapat korelasi yang bermakna (p>0,05) antara tingkat kepatuhan terhadap gender, tingkat pendidikan, status pekerjaan, riwayat penyakit keluarga, kejadian komplikasi, dan pengalaman mendapatkan informasi mengenai hipertensi dan pola diet. Terdapat korelasi bermakana antara status tekanan darah (terkontrol dan tidak terkontrol) terhadap kepatuhan responden (p=0,000). Lebih dari 50% pasien hipertensi di fasilitas kesehatan tingkat pertama di Kota Bandung masih memiliki tingkat kepatuhan yang rendah terhadap pengobatanya dengan rate kepatuhan pasien hipertensi terhadap pengobatanya sebesar 26,3%.

Kata kunci: Hipertensi, tingkat kepatuhan, fasilitas kesehatan tingkat pertama

Medication Adherence among Hypertensive Patients in Primary Healthcare in Bandung City

Abstract
Hypertension is a disease with high mortality and also mobility all over the world. The prevalence of hypertension is increasing every year and West Java is ranked fourth with a prevalence by 29.4%. This study aimed to measure the level of medication adherence of hypertensive patients by using Eight-Item Morisky Medication Adherence Scale (MMAS-8) questionnaire. This study was an observational study using cross sectional design and conducted in October 2017–February 2018 at primary healthcare facilities in Bandung City. A total of two hundred and twenty-six respondents were involved in the study. Respondents are required to fill out the validated Indonesian version of MMAS-8 questionnaire after signing informed consent. The results showed that 53.5% of the respondents had low level of adherence, 32.3% of the respondents had moderate level of adherence, and 14.2% of the respondents had high level of adherence. Then, data were processed statistically by using Chi-Square analysis and the results showed that there was significant correlation (p>0.05) between the level of adherence to gender, education level, occupational status, family history of disease, incidence of complications, and experience with information about hypertension and diet. There was a significant correlation between the status of blood pressure (controlled and uncontrolled) to respondent’s adherence (p=0.000). In addition, more than 50% hypertensive patients in primary health care in Bandung City still has low level of medications adherence with rate of adherence is 26.3%.

Keywords: Hypertension, level of adherence, primary health care

Keywords

Hipertensi; tingkat kepatuhan; fasilitas kesehatan tingkat pertama

Full Text:

PDF (Bahasa Indonesia)

References

Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar Republik Indonesia (2013). Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.

Dinas Kesehatan Jawa Barat. Profil Kesehatan Jawa Barat. Bandung: Dinas Kesehatan Jawa Barat; 2015.

Kementerian Kesehatan Republik Indonesia. Survei Indikator Kesehatan Nasional (Sirkesnas). Jakarta: Kementerian Kesehatan Republik Indonesia; 2016.

Profil Kesehatan Kota Bandung. Bandung: Dinas Kesehatan Kota Bandung; 2016.

Ewald DR, Haldeman LA. Risk factors in adolescent hypertension. Global Pediatr Health. 2016;3:2333794X15625159. doi: 10.1177/2333794X15625159

Jiang B, Liu H, Ru X, Zhang H, Wu S, Wang W. Hypertension detection, management, control and associated factors among residents accessing community health services in Beijing. Sci Rep. 2014;4:4845. doi: 10.1038/srep04845.

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2017. doi: 10.1016/j.jacc.2017.11.006

Gwadry-Sridhar FH, Manias E, Lal L, Salas M, Hughes DA, Ratzki-Leewing A, et al. Impact of interventions on medication adherence and blood pressure control in patients with essential hypertension: A systematic review by the ISPOR medication adherence and persistence special interest group. Value Health. 2013;16(5):863–71. doi: 10.1016/j.jval.2013.03.1631

Parati G, Omboni S, Compare A, Grossi E, Callus E, Venco A, et al. Blood pressure control and treatment adherence in hypertensive patients with metabolic syndrome: Protocol of a randomized controlled study based on home blood pressure telemonitoring vs. conventional management and assessment of psychological determinants of adherence (TELEBPMET Study). Trials. 2013;14:22. doi: 10.1186/1745-6215-14-22.

Irazola VE, Gutierrez L, Bloomfield GS, Carrillo-Larco RM, Dorairaj P, Gaziano T, et al. Hypertension prevalence, awareness, treatment, and control in selected communities of nine low and middle income countries: Results from the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases. Glob Heart. 2016;11(1):47–59. doi: 10.1016/j.gheart.2015.12.008.

Nahimana MR, Nyandwi A, Muhimpundu MA, Olu O, Condo JU, Rusanganwa A, et al. A population-based national estimate of the prevalence and risk factors associated with hypertension in Rwanda: Implications for prevention and control. BMC Public Health. 2018;18:2. doi: 10.1186/s12889-017-4536-9

Lopez JP, Camacho LPA, Arbelaez DG, Alvarado L, Molina DI, Sanchez G, et al. PP.29.11: Educational level influence in the prevalence, awareness, treatment and control of hypertension in colombia. J Hypertens. 2015;33:e392-3. doi: 10.1097/01.hjh.0000468603.20917.d5

Mezuk B, Kershaw KN, Hudson D, Lim KA, Ratliff S. Job strain, workplace discrimination, and hypertension among older workers: The health and retirement study. Race Soc Probl. 2011;3(1):38–50. doi: 10.1007/s12552-011-9041-7

Olesen K, Carneiro IG, Jørgensen MB, Rugulies R, Rasmussen CDN, Søgaard K, et al. Associations between psychosocial work environment and hypertension among non-Western immigrant and Danish cleaners. Int Arch Occup Environ Health. 2012;85(7):829–35. doi: 10.1007/s00420-011-0728-2

Morello CM, Chynoweth M, Kim H, Singh RF, Hirsch JD. Strategies to improve medication adherence reported by diabetes patients and caregivers: Results of a taking control of your diabetes survey. Ann Pharmacother. 2011;45(2):145–53. doi: 10.1345/aph.1P322.

Joho AA. Factors affecting treatment compliance among hypertension patiesnts in three district hospital-Dar es Salaam. Dar es Salaam: Muhimbili University of Health and Allied Science; 2012.

Ambaw AD, Alemie GA, W/Yohannes SM, Mengesha ZB. Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health. 2012;12:282. doi: 10.1186/1471-2458-12-282

Akoko BM, Fon PN, Ngu RC, Ngu KB. Knowledge of hypertension and compliance with therapy among hypertensive patients in the bamenda health district of cameroon: A cross-sectional study. Cardiol Ther. 2017;6(1):53–67. doi: 10.1007/s40119-016-0079-x

Gede SI. The level of medication compliance of hypertension in adults and elderly patient. J Hypertens. 2015;33:e43. doi: 10.1097/01.hjh.0000469883.58487.e6

Boima V, Ademola AD, Odusola AO, Agyekum F, Nwafor CE, Cole H, et al. Factors associated with medication nonadherence among hypertensives in Ghana and Nigeria. Int J Hypertens. 2015;2015:205716. doi: 10.1155/2015/205716

Lee GKY, Wang HHX, Liu KQL, Cheung Y, Morisky DE, Wong MCS. Determinants of medication adherence to antihypertensive medications among a Chinese population using morisky medication adherence scale. PLoS ONE. 2013;8(4):e62775. doi: 10.1371/journal.pone.0062775

Lulebo AM, Mutombo PB, Mapatano MA, Mafuta EM, Kayembe PK, Ntumba LT, et al. Predictors of non-adherence to antihypertensive medication in Kinshasa, democratic Republic of Congo: A cross-sectional study. BMC Res Notes. 2015;8:526. doi: 10.1186/s13104-015-1519-8

Schneider KI, Schmidtke J. Patient compliance based on genetic medicine: A literature review. J Community Genet. 2014;5(1):31-48. doi: 10.1007/s12687-013-0160-2.

Vrijens B, Antoniou S, Burnier M, de la Sierra A, Volpe M. Current situation of medication adherence in hypertension. Fronti Pharmacol. 2017;8:100. doi: 10.33 89/fphar.2017.00100.

Kim HJ, Yoon SJ, Oh IH, Lim JH, Kim YA. Medication adherence and the occurrence of complications in patients with newly diagnosed hypertension. Korean Circ J. 2016;46(3):384–93. doi: 10.4070/kcj.2 016.46.3.384

Kilic M, Uzunçakmak T, Ede H. The effect of knowledge about hypertension on the control of high blood pressure. Int J Cardiovascular Academy. 2016;2(1):27–32. doi: 10.1016/j.ijcac.2016.01.003

Lu CH, Tang ST, Lei YX, Zhang MQ, Lin WQ, Ding SH, et al. Community-based interventions in hypertensive patients: A comparison of three health education strategies. BMC Public Health. 2015;15:33. doi: 10.1186/s12889-015-1401-6

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults report from the panel members appointed to the Eighth Joint National Committee (JNC 8). J Am Med Assoc. 2014;311(5):507–20. doi:10.1001/jama.2013.284427