VALIDASI 8-ITEM MORISKY MEDICATION ADHERENCE SCALE VERSI INDONESIA PADA PASIEN HIPERTENSI DEWASA DI PUSKESMAS KABUPATEN SLEMAN DAN KOTA YOGYAKARTA

DEFILIA ANOGRA RIANI, Prof. Zullies Ikawati., Ph.D., Apt.;Dr. Susi Ari Kristina, S. Farm., M. Kes., Apt.

2017 | Tesis | S2 Ilmu Farmasi

Kepatuhan pasien dapat diukur menggunakan kuesioner 8-item Morisky Medication Adherence Scale (MMAS-8). Di Indonesia, kuesioner MMAS-8 sering digunakan untuk mengukur tingkat kepatuhan pasien, namun penelitian mengenai validasi MMAS-8 versi Indonesia belum pernah dilakukan, sehingga masih belum ada standar baku kuesioner MMAS-8 versi Indonesia yang digunakan dalam penelitian untuk mengukur tingkat kepatuhan pasien. Tujuan dari penelitian ini adalah untuk melakukan validasi dengan menentukan psychometric properties 8-item Morisky Medication Adherence Scale (MMAS-8) versi Indonesia pada pasien yang mengkonsumsi obat antihipertensi di Puskesmas wilayah Sleman dan Yogyakarta. Penelitian menggunakan rancangan observasional dengan pendekatan cross-sectional. Sampel diperoleh dengan metode convenience sampling dalam jangka waktu 3 bulan di 8 puskesmas dan diperoleh jumlah responden sebanyak 250 responden pasien hipertensi. Validitas ditentukan menggunakan known groups validity yang ditentukan berdasarkan asosiasi dari tingkat tekanan darah dan kategori tingkat kepatuhan pasien menggunakan Chi square (X²) test, validitas juga dilakukan dengan convergent validity menggunakan Spearman's rank correlation antara skor MMAS-8 dan skor MMAS-4 (four item original Morisky scale), sedangkan reliabialitas diuji dengan mengukur internal consistency reliability yang dinilai menggunakan Cronbach's alpha coefficient dan test-retest reliability menggunakan Spearman's rank correlation. Sensitivity, specificity, positive dan negative predictive akan ditentukan berdasarkan data validasi. Hasil psychometric properties uji reliabilitas dan uji validitas menunjukkan bahwa MMAS-8 versi Indonesia memiliki reliabilitas dan validitas yang baik dengan hasil internal consistency reliability yang dinilai menggunakan Cronbach's alpha coefficient adalah 0,824 dan hasil uji test-retest reliability menggunakan Spearman's rank correlation adalah 0,881. Hasil Uji known groups validity menunjukkan korelasi signifikan antara pengukuran tekanan darah pasien dengan masing-masing kategori tingkat kepatuhan pasien dalam MMAS-8 ( X²= 26,987; P<0,05) dan hasil convergent validity pada MMAS-8 versi Indonesia adalah r = 0,883, dengan nilai sensitivitas = 82,575% dan nilai spesifisitas = 44,915%.

Patient compliance can be measured using a questionnaire 8- Morisky item Medication adherence Scale (MMAS-8). In Indonesia, the questionnaire MMAS-8 is often used to measure the level of compliance of patients, but research on the validation MMAS-8 versions of Indonesia has not been done, so there is still no gold standard questionnaire MMAS-8 of Indonesian version which used in research to measure the level of patient compliance. The purpose of this study was to validate the psychometric properties determining the MMAS-8 of Indonesian version in patients taking antihypertensive drugs in primary health care Sleman district and Yogyakarta city. The study used cross-sectional survey method. Samples obtained by convenience sampling method in a period of 3 months in 8 primary health cares and obtained the number of respondents was 250 respondents in hypertensive patients. Validity is determined using known groups validity is determined based on the association of blood pressure levels and categories of the level of compliance of patients using the Chi-square (X²) test, the validity is also done by convergent validity using Spearman's rank correlation between scores MMAS-8 and score MMAS-4 (four items Morisky original scale), reliability is determined by measuring the internal consistency reliability were assessed using Cronbach's alpha coefficient and test-retest reliability using Spearman's rank correlation. Sensitivity, specificity, positive and negative predictive validation will be determined based on the data. The results of psychometric properties of reliability test and validity test showed that the MMAS-8 versions of Indonesia has high reliability and validity well with the results of internal consistency reliability were assessed using Cronbach's alpha coefficient was 0.824 and the test results of test-retest reliability using Spearman's rank correlation was 0.881. Test results known groups validity showed a significant correlation between the patient's blood pressure measurements with each category of patient compliance levels in the MMAS-8 (X² = 26.987; P <0.05) and the result of convergent validity on the MMAS-8 versions of Indonesia is r = 0.883 ; sensitivity = 82.575% and specificity = 44.915%.

Kata Kunci : hipertensi, kepatuhan, validasi, MMAS-8 versi Indonesia