Pengaruh Medication Therapy Management Terhadap Kepatuhan, Outcome Klinik Dan Kualitas Hidup Pasien Diabetes Melitus Peserta Program Rujuk Balik Di Kabupaten Sragen

DYAH PURWANTININGSIH, Dr. Nanang Munif Yasin, M.Pharm., Apt.; Dr. Susi Ari Kristina, M.Kes., Apt.

2021 | Tesis | MAGISTER FARMASI KLINIK

INTISARI Diabetes Melitus (DM) merupakan salah satu masalah kesehatan masyarakat yang penting dan masuk dalam empat penyakit noncommunicable diseases (NCDs). Sebagian besar penderita DM belum memahami secara benar pengobatan yang dijalaninya. Ketidakpatuhan dan ketidakpahaman pasien dalam menjalankan terapi merupakan salah satu penyebab kegagalan terapi. Penelitian ini bertujuan untuk melihat pengaruh Medication Therapy Management (MTM) terhadap tingkat kepatuhan, outcome klinik dan kualitas hidup pasien DM peserta Program Rujuk Balik (PRB). Rancangan penelitian ini menggunakan kuasi-ekperimental, dengan desain penelitian pretes-posttes with control group. Bentuk intervensi berupa layanan farmasi berbasis MTM. Subyek penelitian yaitu pasien DM peserta PRB di Kabupaten Sragen yang masuk kriteria inklusi. Instrumen yang digunakan berupa pill count, pengukuran GDP dan DQLCTQ. Analisis data menggunakan uji Mann-whitney atau T-Test. Dari total 106 responden terbagi menjadi dua yaitu 55 responden kelompok kontrol dan 51 responden kelompok intervensi. Setelah dilakukan intervensi berupa layanan farmasi berbasis MTM menunjukan peningkatan kepatuhan pasien sebesar 5,76±9,17 (p=001), peningkatan outcome klinik berupa penurunan GDP sebesar 26,61±42,04 (p=0,010), dan peningkatan kualitas hidup pasien sebesar 2,71±4,83 (p=0,018). Intervensi berupa layanan farmasi berbasis MTM dalam penelitian ini memperbaiki semua aspek variabel yang diteliti.

ABSTRACT Diabetes Mellitus (DM) is an important public health problem and is included in four non-communicable diseases (NCDs). Most of the DM sufferers do not understand correctly the treatment they are undergoing. Non-compliance and patient lack of understanding in carrying out therapy is one of the causes of therapy failure. This study aims to determine the effect of Medication Therapy Management (MTM) on the level of adherence, clinical outcomes and quality of life for DM patients of referral-drug programme participants. The design of the study used a quasi-experimental, with research design pretest-posttest with control group. The form of intervention is MTM-based pharmacy services. The research subjects were DM patients of referral-drug programme participants in Sragen Regency, who entered inclusion criteria. The instruments that used was the pill count, GDP measurement and DQLCTQ. The effect of MTM was analyzed using Mann-whitney test and T-test. Of the total 106 respondents divided into two, 55 into control groups and 51 into intervention groups. After the intervention in MTM-based pharmacy services shows that the intervention group has a better value than the control group. In the intervention group, there was an increase in patient compliance by 5.76±9.17 (p=0.001), an increase in clinical outcomes as decrease in GDP by 26.61±42.04 (p=0.010), and the patients quality of life increased by 2.71±4.83 (p=0.018). MTM interventions in this study improved all aspects of the variables examined. Keyword: diabetes mellitus, Medication Therapy Management, compliance, clinical outcome, quality of life

Kata Kunci : Diabetes Melitus, Medication Therapy Management, Kepatuhan, Outcome Klinik, Kualitas Hidup