Identifikasi Ketidakpatuhan Penggunaan Obat pada Pasien Diabetes Melitus

ANISA BERLIANA D A, Dr. apt. Fita Rahmawati, Sp. FRS.

2020 | Skripsi | S1 FARMASI

Diabetes melitus (DM) merupakan penyakit kronis yang ditandai dengan tingginya kadar glukosa darah secara kronis. Kepatuhan terapi merupakan hal penting dalam pengobatan diabetes melitus untuk mencegah terjadinya komplikasi penyakit. Tujuan penelitian ini untuk me-review tingkat kepatuhan, mengidentifikasi dan me-review bentuk dan penyebab ketidakpatuhan penggunaan obat, serta me-review hubungan kepatuhan dengan kontrol glukosa darah pada pasien diabetes melitus. Penelitian ini merupakan penelitian gabungan cross-sectional dan narrative review. Pengambilan data dengan teknik convenience sampling di Puskesmas Banguntapan I dilakukan pada bulan Maret 2020 dengan wawancara menggunakan kuesioner yang disusun oleh tim peneliti. Pencarian literatur review dilakukan pada bulan April-Mei 2020 menggunakan database Pubmed, Proquest, dan Google scholar dengan kata kunci "Adherence" AND "Diabetes Mellitus" AND "Anti-Diabetic Medication" AND "(Factors Affecting Non-Adherence OR Reasons For Non-Adherence OR Form Nonadherence OR Clinical Outcomes)". Analisis data menggunakan cross-tabulation untuk melihat persentase hasil serta deskriptif untuk membahas hasil dan review artikel. Sebanyak 16 responden pasien DM dan 34 artikel yang memenuhi kriteria inklusi dapat diikutsertakan dalam penelitian ini. Hasil review mengenai tingkat kepatuhan menunjukkan bahwa kepatuhan pasien DM rata-rata sebesar 50%-80%. Bentuk ketidakpatuhan paling umum di Puskesmas yaitu pernah tidak menggunakan obat (93,75%) dan menggunakan obat tidak sesuai aturan pakai (68,75%), sementara hasil review yaitu melewatkan dosis dan berhenti minum obat. Penyebab ketidakpatuhan paling umum di Puskesmas yaitu 62,5% telat kontrol atau obat habis, 56,25% lupa, dan 43,75% sibuk, sementara hasil review yaitu lupa, merasa lebih baik atau terkontrol, mengalami efek samping, merasa lebih buruk ketika mengonsumsi obat, dan biaya obat mahal. Hasil review menunjukkan bahwa peningkatan kepatuhan berhubungan dengan kontrol glukosa darah yang lebih baik.

Diabetes mellitus (DM) is a chronic disease characterized by chronic high blood glucose levels. Adherence to medication is important in the treatment of diabetes mellitus to prevent complications of the disease. The purpose of this study is to review the level of adherence, identify and review the forms and causes of non-adherence with drug use, and review the relationship of adherence with blood glucose control in patients with diabetes mellitus. The design of this study is mixed with a cross-sectional study and narrative review. Data collected by the convenience sampling technique at Puskesmas Banguntapan I was conducted in March 2020 with interviews using a questionnaire compiled by the research team. The literature review search was conducted in April-May 2020 using the Pubmed, Proquest, and Google scholar database with the keywords "Adherence" AND "Diabetes Mellitus" AND "Anti-Diabetic Medication" AND "(Factors Affecting Non-Adherence OR Reasons For Non- Adherence OR Form Nonadherence OR Clinical Outcomes)". Data analysis uses cross-tabulation to see the percentage of results and descriptive to discuss the results and article review. A total of 16 DM patient respondents and 34 articles that fulfill the inclusion criteria could be included in this study. The results of articles review regarding the level of adherence showed that DM patient adherence averaged 50%-80%. The most common form of non-adherence at Puskesmas was not using the drugs (93.75%) and using the drugs not according to the rules of use (68.75%), while the results of the review were skipping doses and stop taking medication. The most common causes of non-adherence at Puskesmas were 62.5% late control or out of medicine, 56.25% forgot, and 43.75% were busy, while the results of the review were forgetting, feeling better or controlled, experiencing side effects, feeling worse when taking medication, and expensive drug costs. The results of the review show that increased adherence is associated with better blood glucose control.

Kata Kunci : diabetes melitus, kepatuhan, cross-sectional, narrative review