Pengaruh Edukasi dan Konseling pada Pelayanan Berbasis Medication Therapy Management (MTM) terhadap Persepsi Sakit dan Outcome Klinik Pasien Diabetes Melitus di Puskesmas Kota Yogyakarta
YANVERTY IDDA L, Dr. apt. Nanang Munif Yasin, M.Pharm ; Dr. apt. Tri Murti Andayani, Sp.FRS2021 | Tesis | MAGISTER FARMASI KLINIK
Diabetes Melitus (DM) memerlukan managemen terapi yang tepat salah satu upaya yang diberikan adalah Medication Therapy Management (MTM). Pasien yang mendapatkan MTM memiliki persepsi sakit terhadap penyakitnya menjadi lebih baik dan berpengaruh pada hasil terapi. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian edukasi dan konseling pada pelayanan farmasi berbasis MTM terhadap persepsi sakit dan outcome klinik pada pasien diabetes melitus di Puskesmas Kota Yogyakarta pada periode Maret-April 2020. Jenis penelitian yang digunakan adalah quasi experimental one group with pretest and posttest design. Responden berjumlah 20 orang, merupakan pasien DM tipe 2 yang memenuhi kriteria inklusi serta mendapatkan pelayanan farmasi berbasis MTM oleh apoteker berupa asesmen, edukasi, dan konseling. Varibel yang diukur adalah skor persepsi sakit menggunakan brief illness perception questionnaire (BPI-Q) dan outcome klinik berupa kadar glukosa darah puasa. Analisa menggunakan uji paired sample t-test dengan signifikansi yang digunakan P<0,05. Hasil penelitian diperoleh skor persepsi sakit pasien sebelum mendapatkan edukasi dan konseling 49,95Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±10,41 menjadi 50,45Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±10,06 (P=0,780). Outcome klinik berupa rata-rata kadar glukosa darah puasa semula 128,66Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±43,99 mg/dL menjadi 129,96Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±23,46 mg/dL (P=0,876) setelah mendapatkan edukasi dan konseling. MTM pada penelitian ini bisa meningkatkan skor persepsi sakit pasien terhadap penyakitnya dan pasien mampu mengontrol kadar glukosa darah. Hasil ini diperoleh dari penelitian selama satu bulan. Diperlukan penelitian dengan periode waktu yang lebih lama dan jumlah responden yang lebih banyak
Diabetes mellitus (DM) requires appropriate therapeutic management, one of the efforts given is Medication Therapy Management (MTM). Patients who receive MTM had a better illness perception of their disease and this will affect the outcome of therapy. This study's purpose is to determine the effect of education and conseling on MTM-based pharmacy services on illness perception and clinical outcomes in diabetes mellitus patients at Puskesmas Kota Yogyakarta in the period March-April 2020. The type of study used is a quasi-experimental one group with pretest and posttest design. There were 20 respondents who were type 2 diabetes mellitus patients who met the inclusion criteria and received MTM-based pharmaceutical services by pharmacists in the form of assessment, education, and counseling. The variable measured were the illness perception score using a brief illness perception questionnaire (BPI-Q) and the clinical outcome in the form of fasting blood glucose levels. The analysis using a paired sample t-test with the significance used p <0.05. The results showed that the patient's illness perception score for their disease was measured using the brief illness perception questionnaire (BPI-Q) before receiving the MTM service 49.95Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±10.41 to 50.45Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±10.06 (P=0,780). The clinical outcome was fasting blood glucose levels from 128.66Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±43.99 to 129.96Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã‚Â¯Ãƒï¿½Ã‚Â¿Ãƒï¿½Ã‚Â½Ãƒï¿½Ã¯Â¿Â½ÃƒÂ¯Ã‚Â¿Ã‚Â½Ãƒï¿½Ã¯Â¿Â½Ãƒï¿½Ã‚Â±23.46 (P=0,876) after receiving MTM-based services. receiving MTM-based services. MTM in this study could increase the patient's illness perception score of their disease and the patient was able to control their blood glucose levels. These result were obtained from the study for one month. Research is needed with a longer period and a larger number of respondents.
Kata Kunci : medication therapy management, diabetes melitus, persepsi sakit, outcome klinik, BIP-Q